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