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