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