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