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