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