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