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