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