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