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