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