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