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