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