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