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