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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
H
Y
Z
V
U
Z
D
V
W
S
L
A
O
A
A
N
L
X
Q
U
S
R
U
C
X
A
S
B
W
B
E
I
E
W
P
U
V
E
O
S
B
C
S
D
U
S
T
S
G
C
Q
U
A
O
I
X
I
G
V
R
R
B
W
L
N
V
Z
O
G
I
A
Z
W
E
P
G
O
G
N
B
L
H
X
T
U
M
A
R
M
E
D
I
C
A
R
E
I
I
P
R
O
C
E
D
U
R
E
S
D
I
S
S
R
J
E
E
M
K
P
F
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