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* Settlement of payment will be in accordance with agreed tariff and subject to claims evaluation in line with SPC
* Please request member to contact ADNIC @ 02-4080333 for further details

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Authorization ID Member ID Member Name Clinician Speciality Created Date Created By Status Action
Request ID Authorization ID Member ID Member Name Provider Name Request Type Visit Category Clinician Name Clinician ID Speciality Request Status Request Date Approver Remarks Provider Remarks Created By Cancellation Date Reason for Cancellation