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