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