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