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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
H
W
Y
V
Z
S
I
C
P
J
T
O
H
L
M
E
V
D
R
R
Y
L
P
V
D
G
E
E
O
E
O
J
T
M
O
R
L
H
V
B
B
C
A
Z
G
A
H
C
I
I
R
B
E
J
Q
H
R
I
D
R
E
T
A
D
S
C
A
G
E
C
O
B
I
X
U
P
D
G
R
S
W
L
J
T
N
R
S
C
B
B
E
R
A
C
I
D
E
M
T
U
D
I
A
G
N
O
S
I
S
S
T
H
H
U
H
E
C
A
L
P
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