ISA*00*          *00*          *ZZ*00             *ZZ*               *061006*1610*U*00401**0*P*>~
GS*HC**C00380*061006*1610*6*X*004010X096A1~
ST*837*000000001*~
BHT*0019*00*000001*061006*1610*CH~
REF*87*004010X096A1~
NM1*41*2*AAA Power*****46**~
		PER*IC*Melissa*TE*88810689~
NM1*40*2*Medicare*****46*C00380~
HL*1**20*1~
NM1*85*2*AAA Power*****24*~
N3*202 US Route 1~
		N4*Falmouth*ME*04105~
REF*1C*207036~
		PER*IC*Melissa*TE*88810689~
HL*2*1*22*0~SBR*P*18**UNKNOWN*****MA~
NM1*IL*1*Atwood*Ashley****MI*113446778A~
N3*6600 Busch Blvd Ste 250~
N4*Columbus*OH*43229*~
		DMG*D8*19350621*F~
NM1*PR*2*Medicare*****PI*C00380~
N3*2 Apple Drive*~
N4*Portland*ME*04310~
CLM*Atwood Ashley:09/25/2006*000***32>A>2*Y**Y*Y*********Y~
DTP*434*RD8*20060810-20060810~
DTP*435*DT*20060810~
CL1**1*30 Still patient or expected to return for outpatient services~
REF*G1*081020060810200601~
HI*BK>9330~
HI*BE>61>>>12345~ 
NM1*71*1*Cyr*Jose****24*112112112~
REF*1G*B13579~
LX*1~
SV2*0023*HC>HDHL1*0*UN*6~
DTP*472*D8*20060810~
SE*40*000000001~
GE*85*6~
IEA*1*207036~