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