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