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