ISA|00| |00| |ZZ|ZIRMED |ZZ|947971C9807506 |250818|2237|}|00501|000003409|0|P|^~GS|HP|ZIRMED|947971C9807506|20250818|2237|3409|X|005010X221A1~ST|835|0001~BPR|I|29762.71|C|ACH|CCP|01|031100209|DA|38876542|1520954463||01|055002338|DA|93128821|20250818~TRN|1|000001850757307|1520954463~DTM|405|20250818~N1|PR|KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES~N3|PO BOX 64533~N4|BALTIMORE|MD|21264~PER|CX|EDICLAIMSNCSO|TE|8008132000|EM|EDICLAIMSNCSO@KP.ORG~PER|BL|NEBO|EM|NEHBO@KP.ORG~N1|PE|HOMECENTRIS HOME HEALTH II LLC|XX|1487113239~N3|10 CROSSROADS DR STE 110~N4|OWINGS MILLS|MD|211175464~REF|TJ|833992125~LX|1~CLP|1150-250808155718|1|5600.01|2088.96||MA|172121412|32|9~NM1|QC|1|LAWRENCE|KIMBERLEY||||MI|13123576~NM1|74|1|||Y~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|13123576~REF|G1|1719927418~DTM|232|20250715~DTM|233|20250731~DTM|050|20250811~AMT|AU|5600.01~SVC|HC^1EA21|0|2088.96|0023~DTM|472|20250715~CAS|CO|45|-2131.59||253|42.63~REF|6R|10373748358Z1~AMT|B6|2131.59~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250715~CAS|CO|45|.01~REF|6R|10373748358Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250715~CAS|CO|45|700~REF|6R|10373748358Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20250715~CAS|CO|45|700~REF|6R|10373748358Z4~SVC|HC^G0151|700|0|0421|0~DTM|472|20250717~CAS|CO|45|700~REF|6R|10373748358Z5~SVC|HC^G0299|700|0|0551|0~DTM|472|20250721~CAS|CO|45|700~REF|6R|10373748358Z6~SVC|HC^G0157|700|0|0421|0~DTM|472|20250723~CAS|CO|45|700~REF|6R|10373748358Z7~SVC|HC^G0157|700|0|0421|0~DTM|472|20250724~CAS|CO|45|700~REF|6R|10373748358Z8~SVC|HC^G0151|700|0|0421|0~DTM|472|20250728~CAS|CO|45|700~REF|6R|10373748358Z9~SVC|HC^G0151|700|0|0421|0~DTM|472|20250731~CAS|CO|45|700~REF|6R|10373748358Z10~CLP|1150-250808143334|1|10500.01|2088.96||MA|172121406|32|9~NM1|QC|1|MURNANE|SARA||||MI|19101021~NM1|74|1|||M~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|19101021~REF|G1|1719933953~DTM|232|20250630~DTM|233|20250728~DTM|050|20250811~AMT|AU|10500.01~SVC|HC^1EA21|0|2088.96|0023~DTM|472|20250630~CAS|CO|45|-2131.59||253|42.63~REF|6R|10373411048Z1~AMT|B6|2131.59~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250630~CAS|CO|45|.01~REF|6R|10373411048Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250630~CAS|CO|45|700~REF|6R|10373411048Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20250701~CAS|CO|45|700~REF|6R|10373411048Z4~SVC|HC^G0152|700|0|0431|0~DTM|472|20250703~CAS|CO|45|700~REF|6R|10373411048Z5~SVC|HC^G0151|700|0|0421|0~DTM|472|20250703~CAS|CO|45|700~REF|6R|10373411048Z6~SVC|HC^G0299|700|0|0551|0~DTM|472|20250707~CAS|CO|45|700~REF|6R|10373411048Z7~SVC|HC^G0151|700|0|0421|0~DTM|472|20250707~CAS|CO|45|700~REF|6R|10373411048Z8~SVC|HC^G0152|700|0|0431|0~DTM|472|20250709~CAS|CO|45|700~REF|6R|10373411048Z9~SVC|HC^G0151|700|0|0421|0~DTM|472|20250711~CAS|CO|45|700~REF|6R|10373411048Z10~SVC|HC^G0299|700|0|0551|0~DTM|472|20250714~CAS|CO|45|700~REF|6R|10373411048Z11~SVC|HC^G0151|700|0|0421|0~DTM|472|20250714~CAS|CO|45|700~REF|6R|10373411048Z12~SVC|HC^G0151|700|0|0421|0~DTM|472|20250717~CAS|CO|45|700~REF|6R|10373411048Z13~SVC|HC^G0152|700|0|0431|0~DTM|472|20250717~CAS|CO|45|700~REF|6R|10373411048Z14~SVC|HC^G0152|700|0|0431|0~DTM|472|20250723~CAS|CO|45|700~REF|6R|10373411048Z15~SVC|HC^G0299|700|0|0551|0~DTM|472|20250728~CAS|CO|45|700~REF|6R|10373411048Z16~SVC|HC^G0151|700|0|0421|0~DTM|472|20250728~CAS|CO|45|700~REF|6R|10373411048Z17~CLP|1150-250808141727|1|4900.01|2088.96||MA|172121407|32|9~NM1|QC|1|THELEN|LORRAINE||||MI|611011692~NM1|74|1|||F~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|611011692~REF|G1|1719915727~DTM|232|20250710~DTM|233|20250722~DTM|050|20250811~AMT|AU|4900.01~SVC|HC^1EA21|0|2088.96|0023~DTM|472|20250710~CAS|CO|45|-2131.59||253|42.63~REF|6R|10373341503Z1~AMT|B6|2131.59~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250710~CAS|CO|45|.01~REF|6R|10373341503Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250710~CAS|CO|45|700~REF|6R|10373341503Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20250710~CAS|CO|45|700~REF|6R|10373341503Z4~SVC|HC^G0151|700|0|0421|0~DTM|472|20250711~CAS|CO|45|700~REF|6R|10373341503Z5~SVC|HC^G0151|700|0|0421|0~DTM|472|20250714~CAS|CO|45|700~REF|6R|10373341503Z6~SVC|HC^G0151|700|0|0421|0~DTM|472|20250715~CAS|CO|45|700~REF|6R|10373341503Z7~SVC|HC^G0299|700|0|0551|0~DTM|472|20250716~CAS|CO|45|700~REF|6R|10373341503Z8~SVC|HC^G0151|700|0|0421|0~DTM|472|20250722~CAS|CO|45|700~REF|6R|10373341503Z9~CLP|1150-250808125241|1|4200.01|2216.56||MA|172121401|32|9~NM1|QC|1|KEISTER|PATRICIA||||MI|791028444~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|791028444~REF|G1|1719911769~DTM|232|20250620~DTM|233|20250717~DTM|050|20250811~AMT|AU|4200.01~SVC|HC^1LB21|0|2216.56|0023~DTM|472|20250620~CAS|CO|45|-2261.8||253|45.24~REF|6R|10373021082Z1~AMT|B6|2261.8~SVC|HC^Q5001|.01|0|0421|0~DTM|472|20250620~CAS|CO|45|.01~REF|6R|10373021082Z2~SVC|HC^G0151|700|0|0421|0~DTM|472|20250620~CAS|CO|45|700~REF|6R|10373021082Z3~SVC|HC^G0157|700|0|0421|0~DTM|472|20250625~CAS|CO|45|700~REF|6R|10373021082Z4~SVC|HC^G0299|700|0|0551|0~DTM|472|20250626~CAS|CO|45|700~REF|6R|10373021082Z5~SVC|HC^G0299|700|0|0551|0~DTM|472|20250703~CAS|CO|45|700~REF|6R|10373021082Z6~SVC|HC^G0299|700|0|0551|0~DTM|472|20250710~CAS|CO|45|700~REF|6R|10373021082Z7~SVC|HC^G0299|700|0|0551|0~DTM|472|20250717~CAS|CO|45|700~REF|6R|10373021082Z8~CLP|1150-250808125347|1|700.01|172.54||MA|172121405|32|9~NM1|QC|1|KEISTER|PATRICIA||||MI|791028444~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|791028444~REF|G1|1719933642~DTM|232|20250724~DTM|233|20250724~DTM|050|20250811~AMT|AU|700.01~SVC|HC^3LB21|0|172.54|0023~DTM|472|20250724~CAS|CO|45|-176.06||253|3.52~REF|6R|10373022732Z1~AMT|B6|176.06~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250724~CAS|CO|45|.01~REF|6R|10373022732Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250724~CAS|CO|45|700~REF|6R|10373022732Z3~CLP|1150-250808123457|1|5600.01|2088.96||MA|172121399|32|9~NM1|QC|1|THOMAS|DARLENE||||MI|63250074~NM1|74|1|||A~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|63250074~REF|G1|1719868241~DTM|232|20250625~DTM|233|20250708~DTM|050|20250811~AMT|AU|5600.01~SVC|HC^1EA21|0|2088.96|0023~DTM|472|20250625~CAS|CO|45|-2131.59||253|42.63~REF|6R|10372894492Z1~AMT|B6|2131.59~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250625~CAS|CO|45|.01~REF|6R|10372894492Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250625~CAS|CO|45|700~REF|6R|10372894492Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20250625~CAS|CO|45|700~REF|6R|10372894492Z4~SVC|HC^G0299|700|0|0551|0~DTM|472|20250630~CAS|CO|45|700~REF|6R|10372894492Z5~SVC|HC^G0157|700|0|0421|0~DTM|472|20250701~CAS|CO|45|700~REF|6R|10372894492Z6~SVC|HC^G0157|700|0|0421|0~DTM|472|20250702~CAS|CO|45|700~REF|6R|10372894492Z7~SVC|HC^G0157|700|0|0421|0~DTM|472|20250705~CAS|CO|45|700~REF|6R|10372894492Z8~SVC|HC^G0157|700|0|0421|0~DTM|472|20250707~CAS|CO|45|700~REF|6R|10372894492Z9~SVC|HC^G0151|700|0|0421|0~DTM|472|20250708~CAS|CO|45|700~REF|6R|10372894492Z10~CLP|1150-250808135357|1|4200.01|2088.96||MA|172121403|32|9~NM1|QC|1|CARR|SELINA||||MI|26265911~NM1|74|1|||C~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|26265911~REF|G1|1719978505~DTM|232|20250713~DTM|233|20250728~DTM|050|20250811~AMT|AU|4200.01~SVC|HC^1EA21|0|2088.96|0023~DTM|472|20250713~CAS|CO|45|-2131.59||253|42.63~REF|6R|10373248560Z1~AMT|B6|2131.59~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250713~CAS|CO|45|.01~REF|6R|10373248560Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250713~CAS|CO|45|700~REF|6R|10373248560Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20250714~CAS|CO|45|700~REF|6R|10373248560Z4~SVC|HC^G0152|700|0|0431|0~DTM|472|20250716~CAS|CO|45|700~REF|6R|10373248560Z5~SVC|HC^G0299|700|0|0551|0~DTM|472|20250716~CAS|CO|45|700~REF|6R|10373248560Z6~SVC|HC^G0157|700|0|0421|0~DTM|472|20250721~CAS|CO|45|700~REF|6R|10373248560Z7~SVC|HC^G0299|700|0|0551|0~DTM|472|20250728~CAS|CO|45|700~REF|6R|10373248560Z8~CLP|1150-250808141031|1|4200.01|1373.38||MA|172121149|32|9~NM1|QC|1|JOHNSON|ALEXIS||||MI|52271927~NM1|74|1|||L|||C|52271627~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|52271627~REF|G1|1719870408~DTM|232|20250708~DTM|233|20250729~DTM|050|20250811~AMT|AU|4200.01~SVC|HC^3EA21|0|1373.38|0023~DTM|472|20250708~CAS|CO|45|-1401.41||253|28.03~REF|6R|10373313055Z1~AMT|B6|1401.41~SVC|HC^Q5001|.01|0|0421|0~DTM|472|20250708~CAS|CO|45|.01~REF|6R|10373313055Z2~SVC|HC^G0151|700|0|0421|0~DTM|472|20250708~CAS|CO|45|700~REF|6R|10373313055Z3~SVC|HC^G0152|700|0|0431|0~DTM|472|20250715~CAS|CO|45|700~REF|6R|10373313055Z4~SVC|HC^G0151|700|0|0421|0~DTM|472|20250715~CAS|CO|45|700~REF|6R|10373313055Z5~SVC|HC^G0151|700|0|0421|0~DTM|472|20250723~CAS|CO|45|700~REF|6R|10373313055Z6~SVC|HC^G0152|700|0|0431|0~DTM|472|20250724~CAS|CO|45|700~REF|6R|10373313055Z7~SVC|HC^G0151|700|0|0421|0~DTM|472|20250729~CAS|CO|45|700~REF|6R|10373313055Z8~CLP|1150-250808164300|1|5600.01|1373.18||MA|172121411|32|9~NM1|QC|1|KNOTTS|CHARLOTTE||||MI|37278680~NM1|74|1|||M~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|37278680~REF|G1|1719859797~DTM|232|20250702~DTM|233|20250731~DTM|050|20250811~AMT|AU|5600.01~SVC|HC^3LB11|0|1373.18|0023~DTM|472|20250702~CAS|CO|45|-1401.2||253|28.02~REF|6R|10373914081Z1~AMT|B6|1401.2~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250702~CAS|CO|45|.01~REF|6R|10373914081Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250702~CAS|CO|45|700~REF|6R|10373914081Z3~SVC|HC^G0152|700|0|0431|0~DTM|472|20250703~CAS|CO|45|700~REF|6R|10373914081Z4~SVC|HC^G0152|700|0|0431|0~DTM|472|20250708~CAS|CO|45|700~REF|6R|10373914081Z5~SVC|HC^G0299|700|0|0551|0~DTM|472|20250710~CAS|CO|45|700~REF|6R|10373914081Z6~SVC|HC^G0299|700|0|0551|0~DTM|472|20250716~CAS|CO|45|700~REF|6R|10373914081Z7~SVC|HC^G0152|700|0|0431|0~DTM|472|20250716~CAS|CO|45|700~REF|6R|10373914081Z8~SVC|HC^G0299|700|0|0551|0~DTM|472|20250725~CAS|CO|45|700~REF|6R|10373914081Z9~SVC|HC^G0299|700|0|0551|0~DTM|472|20250731~CAS|CO|45|700~REF|6R|10373914081Z10~CLP|1150-250808144929|1|5600.01|2395.77||MA|172121408|32|9~NM1|QC|1|MECKE|PETER||||MI|43286176~NM1|74|1|||H~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|43286176~REF|G1|1719927548~DTM|232|20250716~DTM|233|20250728~DTM|050|20250811~AMT|AU|5600.01~SVC|HC^1EA31|0|2395.77|0023~DTM|472|20250716~CAS|CO|45|-2444.66||253|48.89~REF|6R|10373473134Z1~AMT|B6|2444.66~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250716~CAS|CO|45|.01~REF|6R|10373473134Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250716~CAS|CO|45|700~REF|6R|10373473134Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20250716~CAS|CO|45|700~REF|6R|10373473134Z4~SVC|HC^G0151|700|0|0421|0~DTM|472|20250718~CAS|CO|45|700~REF|6R|10373473134Z5~SVC|HC^G0151|700|0|0421|0~DTM|472|20250721~CAS|CO|45|700~REF|6R|10373473134Z6~SVC|HC^G0299|700|0|0551|0~DTM|472|20250721~CAS|CO|45|700~REF|6R|10373473134Z7~SVC|HC^G0151|700|0|0421|0~DTM|472|20250723~CAS|CO|45|700~REF|6R|10373473134Z8~SVC|HC^G0151|700|0|0421|0~DTM|472|20250725~CAS|CO|45|700~REF|6R|10373473134Z9~SVC|HC^G0151|700|0|0421|0~DTM|472|20250728~CAS|CO|45|700~REF|6R|10373473134Z10~CLP|1150-250808140336|1|11200.01|2403.36||MA|172121404|32|9~NM1|QC|1|FRANKLIN|BEVERLY||||MI|71292905~NM1|74|1|||J~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|71292905~REF|G1|1719953276~DTM|232|20250705~DTM|233|20250730~DTM|050|20250811~AMT|AU|11200.01~SVC|HC^1AC21|0|2403.36|0023~DTM|472|20250705~CAS|CO|45|-2452.41||253|49.05~REF|6R|10373280089Z1~AMT|B6|2452.41~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250705~CAS|CO|45|.01~REF|6R|10373280089Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250705~CAS|CO|45|700~REF|6R|10373280089Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20250708~CAS|CO|45|700~REF|6R|10373280089Z4~SVC|HC^G0152|700|0|0431|0~DTM|472|20250710~CAS|CO|45|700~REF|6R|10373280089Z5~SVC|HC^G0299|700|0|0551|0~DTM|472|20250711~CAS|CO|45|700~REF|6R|10373280089Z6~SVC|HC^G0151|700|0|0421|0~DTM|472|20250711~CAS|CO|45|700~REF|6R|10373280089Z7~SVC|HC^G0151|700|0|0421|0~DTM|472|20250714~CAS|CO|45|700~REF|6R|10373280089Z8~SVC|HC^G0299|700|0|0551|0~DTM|472|20250715~CAS|CO|45|700~REF|6R|10373280089Z9~SVC|HC^G0151|700|0|0421|0~DTM|472|20250716~CAS|CO|45|700~REF|6R|10373280089Z10~SVC|HC^G0152|700|0|0431|0~DTM|472|20250716~CAS|CO|45|700~REF|6R|10373280089Z11~SVC|HC^G0299|700|0|0551|0~DTM|472|20250717~CAS|CO|45|700~REF|6R|10373280089Z12~SVC|HC^G0299|700|0|0551|0~DTM|472|20250722~CAS|CO|45|700~REF|6R|10373280089Z13~SVC|HC^G0152|700|0|0431|0~DTM|472|20250722~CAS|CO|45|700~REF|6R|10373280089Z14~SVC|HC^G0157|700|0|0421|0~DTM|472|20250724~CAS|CO|45|700~REF|6R|10373280089Z15~SVC|HC^G0299|700|0|0551|0~DTM|472|20250729~CAS|CO|45|700~REF|6R|10373280089Z16~SVC|HC^G0151|700|0|0421|0~DTM|472|20250729~CAS|CO|45|700~REF|6R|10373280089Z17~SVC|HC^G0152|700|0|0431|0~DTM|472|20250730~CAS|CO|45|700~REF|6R|10373280089Z18~CLP|1150-250808150327|1|2100.01|2053.2||MA|172121409|32|9~NM1|QC|1|LOWDER|HONTZE||||MI|16331106~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|16331106~REF|G1|1719869815~DTM|232|20250710~DTM|233|20250731~DTM|050|20250811~AMT|AU|2100.01~SVC|HC^3CA21|0|2053.2|0023~DTM|472|20250710~CAS|CO|45|-2095.1||253|41.9~REF|6R|10373530991Z1~AMT|B6|2095.1~SVC|HC^Q5001|.01|0|0421|0~DTM|472|20250710~CAS|CO|45|.01~REF|6R|10373530991Z2~SVC|HC^G0151|700|0|0421|0~DTM|472|20250710~CAS|CO|45|700~REF|6R|10373530991Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20250724~CAS|CO|45|700~REF|6R|10373530991Z4~SVC|HC^G0151|700|0|0421|0~DTM|472|20250731~CAS|CO|45|700~REF|6R|10373530991Z5~CLP|1150-250808124025|1|5600.01|1961.14||MA|172121400|32|9~NM1|QC|1|HAYWOOD|CHARLES||||MI|54347166~NM1|74|1|HAYWOOD JR||C~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|54347166~REF|G1|1719946965~DTM|232|20250718~DTM|233|20250730~DTM|050|20250811~AMT|AU|5600.01~SVC|HC^1EA11|0|1961.14|0023~DTM|472|20250718~CAS|CO|45|-2001.16||253|40.02~REF|6R|10372940647Z1~AMT|B6|2001.16~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250718~CAS|CO|45|.01~REF|6R|10372940647Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250718~CAS|CO|45|700~REF|6R|10372940647Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20250718~CAS|CO|45|700~REF|6R|10372940647Z4~SVC|HC^G0157|700|0|0421|0~DTM|472|20250723~CAS|CO|45|700~REF|6R|10372940647Z5~SVC|HC^G0157|700|0|0421|0~DTM|472|20250724~CAS|CO|45|700~REF|6R|10372940647Z6~SVC|HC^G0299|700|0|0551|0~DTM|472|20250725~CAS|CO|45|700~REF|6R|10372940647Z7~SVC|HC^G0157|700|0|0421|0~DTM|472|20250725~CAS|CO|45|700~REF|6R|10372940647Z8~SVC|HC^G0157|700|0|0421|0~DTM|472|20250729~CAS|CO|45|700~REF|6R|10372940647Z9~SVC|HC^G0151|700|0|0421|0~DTM|472|20250730~CAS|CO|45|700~REF|6R|10372940647Z10~CLP|1150-250808124547|1|5600.01|2088.96||MA|172121136|32|9~NM1|QC|1|SLOUGH|KAI||||MI|721293540~NM1|74|1||||||C|721293240~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|721293240~REF|G1|1719713704~DTM|232|20250630~DTM|233|20250715~DTM|050|20250811~AMT|AU|5600.01~SVC|HC^1EA21|0|2088.96|0023~DTM|472|20250630~CAS|CO|45|-2131.59||253|42.63~REF|6R|10372983999Z1~AMT|B6|2131.59~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250630~CAS|CO|45|.01~REF|6R|10372983999Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250630~CAS|CO|45|700~REF|6R|10372983999Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20250630~CAS|CO|45|700~REF|6R|10372983999Z4~SVC|HC^G0151|700|0|0421|0~DTM|472|20250702~CAS|CO|45|700~REF|6R|10372983999Z5~SVC|HC^G0299|700|0|0551|0~DTM|472|20250707~CAS|CO|45|700~REF|6R|10372983999Z6~SVC|HC^G0151|700|0|0421|0~DTM|472|20250708~CAS|CO|45|700~REF|6R|10372983999Z7~SVC|HC^G0151|700|0|0421|0~DTM|472|20250710~CAS|CO|45|700~REF|6R|10372983999Z8~SVC|HC^G0151|700|0|0421|0~DTM|472|20250714~CAS|CO|45|700~REF|6R|10372983999Z9~SVC|HC^G0151|700|0|0421|0~DTM|472|20250715~CAS|CO|45|700~REF|6R|10372983999Z10~CLP|1150-250811171657|1|7000|1330||HM|172168431|32|3~NM1|QC|1|GREEN|NORMA||||MI|34171716~NM1|74|1|||J~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|34171716~REF|G1|1719952851~DTM|232|20250724~DTM|233|20250808~DTM|050|20250812~AMT|AU|7000~SVC|HC^G0151|700|139|0421~DTM|472|20250724~CAS|CO|45|561~REF|6R|10384430989Z1~AMT|B6|139~SVC|HC^G0299|700|119|0551~DTM|472|20250725~CAS|CO|45|581~REF|6R|10384430989Z2~AMT|B6|119~SVC|HC^G0152|700|139|0431~DTM|472|20250728~CAS|CO|45|561~REF|6R|10384430989Z3~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20250729~CAS|CO|45|561~REF|6R|10384430989Z4~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20250731~CAS|CO|45|561~REF|6R|10384430989Z5~AMT|B6|139~SVC|HC^G0299|700|119|0551~DTM|472|20250801~CAS|CO|45|581~REF|6R|10384430989Z6~AMT|B6|119~SVC|HC^G0152|700|139|0431~DTM|472|20250804~CAS|CO|45|561~REF|6R|10384430989Z7~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20250805~CAS|CO|45|561~REF|6R|10384430989Z8~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20250807~CAS|CO|45|561~REF|6R|10384430989Z9~AMT|B6|139~SVC|HC^G0299|700|119|0551~DTM|472|20250808~CAS|CO|45|581~REF|6R|10384430989Z10~AMT|B6|119~CLP|1150-250811131908|1|2800|646.32||HM|172168968|32|3~NM1|QC|1|CHANG|CANDICE||||MI|85187624~NM1|74|1|||K~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|85187624~REF|G1|1719927157~DTM|232|20250708~DTM|233|20250721~DTM|050|20250812~AMT|AU|2800~SVC|HC^G0157|700|167.89|0421~DTM|472|20250708~CAS|CO|45|532.11~REF|6R|10383318959Z1~AMT|B6|167.89~SVC|HC^G0299|700|155.27|0551~DTM|472|20250714~CAS|CO|45|544.73~REF|6R|10383318959Z2~AMT|B6|155.27~SVC|HC^G0157|700|167.89|0421~DTM|472|20250717~CAS|CO|45|532.11~REF|6R|10383318959Z3~AMT|B6|167.89~SVC|HC^G0299|700|155.27|0551~DTM|472|20250721~CAS|CO|45|544.73~REF|6R|10383318959Z4~AMT|B6|155.27~CLP|1150-250811161449|1|5600|1303.5||HM|172168969|32|2~NM1|QC|1|PHILOGENE ABRAHAM|MARIECLAUDET||||MI|44221791~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|44221791~REF|G1|1719975628~DTM|232|20250716~DTM|233|20250731~DTM|050|20250812~AMT|AU|5600~SVC|HC^G0299|700|155.27|0551~DTM|472|20250716~CAS|CO|45|544.73~REF|6R|10384137259Z1~AMT|B6|155.27~SVC|HC^G0152|700|171.51|0431~DTM|472|20250717~CAS|CO|45|528.49~REF|6R|10384137259Z2~AMT|B6|171.51~SVC|HC^G0299|700|155.27|0551~DTM|472|20250723~CAS|CO|45|544.73~REF|6R|10384137259Z3~AMT|B6|155.27~SVC|HC^G0152|700|171.51|0431~DTM|472|20250724~CAS|CO|45|528.49~REF|6R|10384137259Z4~AMT|B6|171.51~SVC|HC^G0299|700|155.27|0551~DTM|472|20250725~CAS|CO|45|544.73~REF|6R|10384137259Z5~AMT|B6|155.27~SVC|HC^G0151|700|167.89|0421~DTM|472|20250729~CAS|CO|45|532.11~REF|6R|10384137259Z6~AMT|B6|167.89~SVC|HC^G0299|700|155.27|0551~DTM|472|20250730~CAS|CO|45|544.73~REF|6R|10384137259Z7~AMT|B6|155.27~SVC|HC^G0152|700|171.51|0431~DTM|472|20250731~CAS|CO|45|528.49~REF|6R|10384137259Z8~AMT|B6|171.51~SE|849|0001~GE|1|3409~IEA|1|000003409~