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