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