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