Wicanja Health

Claims Submission

Demo — submit medicine or doctor-visit claims for adjudication.

MEMBER IDENTITY NUMBER

NAPPI CODE

MEDICINE NAME

QUANTITY

LODGED AMOUNT (R)

SERVICE DATE

PRESCRIBER (optional)

ICD-10 CODE

LODGED AMOUNT (R)

SERVICE DATE

PROVIDER (optional)

Recent Claims — This Member

#	Type	Item	Lodged	Due	Status	Date
No claims yet.