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