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