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