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