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