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