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