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