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