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