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