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