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