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