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