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