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