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Miscellaneous: Claims Adjustments
Claims
Claims Adjustments
Claims
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CHARGES
COB
DATE
DIAGNOSIS
MEDICARE
PLACE
PROCEDURE
PROVIDER
SUBSCRIBER
F
B
F
F
R
I
Z
Z
Z
H
Z
M
S
E
R
U
D
E
C
O
R
P
I
W
E
R
A
C
I
D
E
M
R
K
U
U
T
W
H
Q
B
P
E
O
L
Y
E
Z
A
A
I
R
B
C
V
P
A
H
L
Q
R
N
R
Z
A
I
K
T
W
B
C
G
K
B
L
L
D
P
T
K
S
O
E
Y
K
Q
P
E
W
C
B
Y
B
S
Z
M
S
A
R
W
U
S
I
S
O
N
G
A
I
D
S
B
Z
F
N
C
Z
R
G
Y
M
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