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