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