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