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