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