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