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