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