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