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