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