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