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