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