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