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