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