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