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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
P
R
O
V
I
D
E
R
F
A
U
R
M
C
H
J
A
D
W
F
H
J
O
E
E
R
A
Q
I
X
C
Z
F
C
D
B
W
Z
T
A
V
S
U
C
E
I
E
I
F
E
G
G
N
T
H
D
C
O
K
R
I
N
M
O
K
A
U
A
B
S
N
C
O
W
O
F
R
R
R
T
M
K
O
S
A
Y
S
G
E
E
U
E
Z
B
I
B
X
F
E
X
S
Y
M
S
Q
S
K
U
R
S
J
O
Z
U
P
L
A
C
E
S
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