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