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