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