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