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