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