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