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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
B
C
U
Z
G
D
T
N
R
K
F
J
T
R
B
R
O
N
B
W
B
E
Z
E
S
W
S
E
O
Y
F
N
W
M
P
R
E
P
C
D
T
U
T
U
B
K
F
A
G
B
R
I
C
Q
W
E
F
I
E
C
R
V
I
V
C
P
C
T
S
G
T
I
A
O
B
O
O
A
X
E
Y
V
A
D
H
Z
E
R
L
R
C
E
R
U
D
E
C
O
R
P
U
J
R
T
Q
M
Q
M
P
I
V
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