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