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