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