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