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