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