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