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