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