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