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