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