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