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