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