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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
D
I
A
G
N
O
S
I
S
B
R
R
I
K
H
E
G
Y
Y
Z
M
O
E
O
G
M
P
P
E
J
Q
M
C
O
B
V
C
Z
L
C
W
N
P
E
H
D
I
I
F
A
W
M
Z
T
D
D
A
X
R
D
C
C
C
N
I
U
A
I
R
N
C
E
G
P
P
O
R
X
T
C
G
H
S
R
F
W
G
E
M
T
E
A
E
H
B
U
S
Z
O
P
K
X
L
R
S
G
U
J
A
O
J
H
O
V
H
E
N
Y
S
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