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