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