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