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