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