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