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