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