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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
P
D
I
A
G
N
O
S
I
S
I
X
O
D
Z
Z
T
G
N
U
U
H
E
E
X
E
L
F
T
B
B
M
D
R
R
T
D
X
J
S
G
P
O
K
U
A
T
B
O
C
Q
X
L
Y
Z
D
C
H
A
R
G
E
S
A
E
T
E
I
F
I
A
Y
F
E
C
Q
Z
C
D
B
M
N
Z
I
W
E
I
M
O
E
K
I
T
H
N
G
E
V
T
R
M
Z
U
J
B
T
K
U
R
U
P
R
O
V
I
D
E
R
V
O
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