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