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