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