MRDI File Example.xlsx

	A	B	C	D	E	F	G	H	I	J	K	L	M
1	SAMPLE FILE FORMAT
2	Last Name	First Name	Birthdate MMDDYYYY	SS #	Sex	MR#	Date of Service MMDDYYYY	Type of Service	ICD-10 Codes	ICD-10	ICD-10	ICD-10	ICD-10
3	DEER	TEMP	07081983	123456789	M	M000599999	01042018	Inpt	C9110	2384
4	BERRY	SAMPLE	11011974	999999999	F	M000555555	11282018	Outpt	C340	C799
5	CAT	KITTY	09201957	266666666	F	M000572777	11132018	Inpt	C50911	C509
6	ROLL	DUFFY	1011933	162222222	F	M000522227	10082015	Outpt	C182
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