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