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