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