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