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