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