311 B
311 B
| 1 | patient id | item | dispense date | count | carrier | supply_type | Billing Staff | Auth Number |
|---|---|---|---|---|---|---|---|---|
| 2 | PT-1171 | G6 | 2026-05-05 | 3 | Medicare Part A | sensor | M. Jones | CGM-2026-001 |
| 3 | PT-1172 | Dexcom G6 Pro | 2026-04-28 | 9 | Medicare Part A | sensor | M. Jones | CGM-2026-001 |
| 4 | PT-1173 | Dexcom G6 | 2026-05-02 | 3 | Medicare Part A | sensor | M. Jones | CGM-2026-001 |