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