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