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