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