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