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