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