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