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