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Miscellaneous: Claims Adjustments
Claims
Claims Adjustments
Claims
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CHARGES
COB
DATE
DIAGNOSIS
MEDICARE
PLACE
PROCEDURE
PROVIDER
SUBSCRIBER
S
Y
F
U
O
Q
M
N
Y
H
W
T
U
E
S
V
L
E
W
I
O
C
E
B
B
F
E
H
E
Y
K
E
S
R
Y
R
S
M
G
R
T
T
R
I
A
C
N
E
C
Q
R
S
A
U
S
C
I
U
O
D
R
P
A
S
D
O
I
O
B
H
N
I
I
F
H
E
N
D
S
H
N
D
S
V
B
G
C
G
E
K
P
Y
V
N
U
O
E
O
A
M
N
T
C
P
I
K
P
R
R
I
C
N
T
J
I
E
C
A
L
P
D
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