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