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