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