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