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