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