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