Inbound Documents - Provider Notes

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Content Type

MMEXSPECR

File Creation Date/Time                                                         

[generate upon submission use e.g. 20200608164859]

Run ID

[use PMS application name abbreviation: 3 characters followed by 7 digits e.g. ACC0000001]

Claim Reference

10047338913

Consulting Provider Name

[use any provider name]

Consult Date

10/05/2021

Metadata for Content Type

[N/A]

Assessment Type

[N/A]

Body Site

[N/A]

Client NHI Number

NHI1261

Client First Name

Sarah

Client Last Name

Strawberry

Client Date of Birth

01-01-2010

File Extension

PDF