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