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