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