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Miscellaneous: Claims Adjustments
Claims
Claims Adjustments
Claims
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CHARGES
COB
DATE
DIAGNOSIS
MEDICARE
PLACE
PROCEDURE
PROVIDER
SUBSCRIBER
O
L
U
Q
Q
C
V
M
F
H
S
E
D
Z
B
K
V
N
G
S
U
D
R
A
I
Z
P
S
C
X
B
D
F
E
V
B
M
Y
E
Y
S
B
I
I
D
B
K
L
W
G
C
O
B
A
S
I
Z
Q
I
R
R
S
B
G
G
S
V
Z
T
B
I
A
I
O
E
N
H
O
W
J
B
J
H
L
T
U
O
E
R
M
E
D
I
C
A
R
E
S
Y
P
R
O
C
E
D
U
R
E
I
O
T
I
T
N
P
L
A
C
E
S
U
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