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