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