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