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