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