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