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