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