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