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