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