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