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