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