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