Generate ANSI X12 Medicaid Export
Generate and DownloadSample Data
| First Name | Last Name | Date | Amount | Provider |
|---|---|---|---|---|
| Isaac | Isaac | 2023-12-01 | $205.80 | Heather Allen |
| Isaac | Isaac | 2023-12-01 | $205.80 | Heather Allen |
| First Name | Last Name | Date | Amount | Provider |
|---|---|---|---|---|
| Isaac | Isaac | 2023-12-01 | $205.80 | Heather Allen |
| Isaac | Isaac | 2023-12-01 | $205.80 | Heather Allen |