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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
T
A
H
B
J
H
A
R
T
F
P
R
O
C
E
D
U
R
E
W
Z
R
M
E
D
I
C
A
R
E
J
Y
O
X
Z
B
C
H
V
K
P
W
Q
V
F
O
P
I
A
E
C
A
L
P
I
W
D
O
X
R
Y
H
J
E
P
D
E
U
E
Q
G
C
H
P
F
A
E
L
T
J
S
E
O
S
S
M
V
R
A
H
G
W
S
B
C
B
N
P
D
I
A
G
N
O
S
I
S
U
T
J
R
V
B
T
G
Y
P
T
R
S
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