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