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