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Miscellaneous: Claims Adjustments
Claims
Claims Adjustments
Claims
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CHARGES
COB
DATE
DIAGNOSIS
MEDICARE
PLACE
PROCEDURE
PROVIDER
SUBSCRIBER
Y
U
R
E
D
I
V
O
R
P
A
B
M
Q
T
R
Q
B
K
M
R
R
L
L
N
N
O
K
F
Y
E
O
C
I
Y
P
M
I
E
E
B
D
C
Y
K
F
I
O
L
C
I
D
I
E
O
E
W
S
E
G
R
A
H
C
D
A
C
S
G
L
C
O
B
D
A
U
V
A
E
Z
S
Q
K
R
T
R
R
N
L
J
B
F
V
R
E
T
E
E
T
P
U
D
I
A
G
N
O
S
I
S
S
U
Q
K
M
G
T
H
M
F
P
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