Springfield Family Practice ยท Provider NPI 1234567890
| Request # | Member | Service | Submitted | Status | |
|---|---|---|---|---|---|
| PA-2025-0409 | Maria Lopez | MRI Lumbar Spine | 03/02/2025 | Approved | |
| PA-2025-0417 | James Anderson | Physical Therapy (12 visits) | 03/05/2025 | Approved | |
| PA-2025-0431 | Priya Shah | Sleep Study | 03/11/2025 | Pending Review |