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