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