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