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