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