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