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