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