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