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