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