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