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