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