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