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