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