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