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