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