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