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