im Format D.0 SXC COMMERCIAL CLAIM FORMAT Cardholder ID 854905597 Quantity Dispensed 30 Times Submilled 5 Store Number 1395 Help Desk Number OwS SuPoly. 30 Reed Codes Response Messages L Third Party OUR 70 - Product/See/ice Not Coerced-PI WIREDHEALTHCARE .COMMERCIAL Adjudication Raja, i Respon