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