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