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