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