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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
Z
S
E
C
H
A
R
G
E
S
P
R
O
C
E
D
U
R
E
Z
I
R
M
E
D
I
C
A
R
E
S
C
O
P
I
B
I
P
P
T
I
A
O
V
V
X
Z
I
O
P
S
E
F
Z
I
O
P
B
Y
R
O
L
E
F
T
D
L
V
M
U
N
C
E
A
W
W
E
R
B
Z
G
O
B
S
P
C
S
R
S
H
A
B
N
G
M
B
I
E
O
Q
I
M
Q
A
V
Z
L
U
C
M
D
K
K
S
J
O
V
D
L
S
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