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