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