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