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