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