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