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