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