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