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