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