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