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