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