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