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