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