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