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