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