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