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