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