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