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