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