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