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