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