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