Inbound Documents - Treatment Extension

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Content Type

MMEX32PHY

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

10047388952

Consulting Provider Name

[use any provider name]

Consult Date

01/06/2021

Metadata for Content Type

[N/A]

Assessment Type

[N/A]

Body Site

[N/A]

Client NHI Number

NHI1234

Client First Name

Andrew

Client Last Name

Apple

Client Date of Birth

27/03/1945

File Extension

PDF