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