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