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