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