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