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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
A
K
U
R
D
T
L
G
I
S
K
U
A
S
I
I
E
I
Y
X
S
M
P
B
N
E
U
E
J
N
E
I
E
Z
R
S
V
G
N
T
A
R
S
R
P
I
E
C
J
R
S
A
U
O
A
L
O
O
D
R
R
A
Z
D
N
C
E
B
W
Q
I
I
P
H
E
G
I
H
M
E
Y
P
V
B
U
C
A
D
P
H
Y
B
J
P
O
E
O
I
E
A
G
I
E
T
E
H
R
R
D
M
R
E
G
B
E
C
A
L
P
I
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