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