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