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