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