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