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