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