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