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