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