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