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