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