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