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