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