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