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