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