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