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