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