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