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