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