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