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