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