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