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