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