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