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