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