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