ISA|00| |00| |ZZ|ZIRMED |ZZ|923001C9807506 |250903|0258|}|00501|000003418|0|P|^~GS|HP|ZIRMED|923001C9807506|20250903|0258|3418|X|005010X221A1~ST|835|0001~BPR|I|13154.33|C|ACH|CCP|01|031100209|DA|38876542|1520954463||01|055002338|DA|93128821|20250903~TRN|1|000001850762656|1520954463~DTM|405|20250903~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|1150-250826121917|1|4900.01|1172.6||MA|172978975|32|9~NM1|QC|1|BOTTO|MARY||||MI|721034412~NM1|74|1|||C~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|721034412~REF|G1|1719821708~DTM|232|20250725~DTM|233|20250813~DTM|050|20250827~AMT|AU|4900.01~SVC|HC^3AA11|0|1172.6|0023~DTM|472|20250725~CAS|CO|45|-1196.53||253|23.93~REF|6R|10465861198Z1~AMT|B6|1196.53~SVC|HC^Q5001|.01|0|0421|0~DTM|472|20250725~CAS|CO|45|.01~REF|6R|10465861198Z2~SVC|HC^G0157|700|0|0421|0~DTM|472|20250725~CAS|CO|45|700~REF|6R|10465861198Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20250730~CAS|CO|45|700~REF|6R|10465861198Z4~SVC|HC^G0151|700|0|0421|0~DTM|472|20250731~CAS|CO|45|700~REF|6R|10465861198Z5~SVC|HC^G0151|700|0|0421|0~DTM|472|20250804~CAS|CO|45|700~REF|6R|10465861198Z6~SVC|HC^G0151|700|0|0421|0~DTM|472|20250805~CAS|CO|45|700~REF|6R|10465861198Z7~SVC|HC^G0151|700|0|0421|0~DTM|472|20250811~CAS|CO|45|700~REF|6R|10465861198Z8~SVC|HC^G0151|700|0|0421|0~DTM|472|20250813~CAS|CO|45|700~REF|6R|10465861198Z9~CLP|1150-250826124201|1|5600.01|2546.2||MA|172978976|32|9~NM1|QC|1|PINKNEY|BRENDA||||MI|911294678~NM1|74|1|||H~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|911294678~REF|G1|1720001753~DTM|232|20250812~DTM|233|20250822~DTM|050|20250827~AMT|AU|5600.01~SVC|HC^1EC21|0|2546.2|0023~DTM|472|20250812~CAS|CO|45|-2598.16||253|51.96~REF|6R|10465949580Z1~AMT|B6|2598.16~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250812~CAS|CO|45|.01~REF|6R|10465949580Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250812~CAS|CO|45|700~REF|6R|10465949580Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20250812~CAS|CO|45|700~REF|6R|10465949580Z4~SVC|HC^G0151|700|0|0421|0~DTM|472|20250813~CAS|CO|45|700~REF|6R|10465949580Z5~SVC|HC^G0151|700|0|0421|0~DTM|472|20250814~CAS|CO|45|700~REF|6R|10465949580Z6~SVC|HC^G0299|700|0|0551|0~DTM|472|20250818~CAS|CO|45|700~REF|6R|10465949580Z7~SVC|HC^G0157|700|0|0421|0~DTM|472|20250819~CAS|CO|45|700~REF|6R|10465949580Z8~SVC|HC^G0157|700|0|0421|0~DTM|472|20250821~CAS|CO|45|700~REF|6R|10465949580Z9~SVC|HC^G0151|700|0|0421|0~DTM|472|20250822~CAS|CO|45|700~REF|6R|10465949580Z10~CLP|1150-250826125201|1|6300.01|2797.12||MA|172978977|32|9~NM1|QC|1|RAY|TERRY||||MI|98309537~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|98309537~REF|G1|1719920815~DTM|232|20250725~DTM|233|20250820~DTM|050|20250827~AMT|AU|6300.01~SVC|HC^3CC31|0|2797.12|0023~DTM|472|20250725~CAS|CO|45|-2854.2||253|57.08~REF|6R|10466026773Z1~AMT|B6|2854.2~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250725~CAS|CO|45|.01~REF|6R|10466026773Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250725~CAS|CO|45|700~REF|6R|10466026773Z3~SVC|HC^G0299|700|0|0551|0~DTM|472|20250728~CAS|CO|45|700~REF|6R|10466026773Z4~SVC|HC^G0299|700|0|0551|0~DTM|472|20250730~CAS|CO|45|700~REF|6R|10466026773Z5~SVC|HC^G0299|700|0|0551|0~DTM|472|20250804~CAS|CO|45|700~REF|6R|10466026773Z6~SVC|HC^G0299|700|0|0551|0~DTM|472|20250806~CAS|CO|45|700~REF|6R|10466026773Z7~SVC|HC^G0299|700|0|0551|0~DTM|472|20250811~CAS|CO|45|700~REF|6R|10466026773Z8~SVC|HC^G0299|700|0|0551|0~DTM|472|20250813~CAS|CO|45|700~REF|6R|10466026773Z9~SVC|HC^G0299|700|0|0551|0~DTM|472|20250818~CAS|CO|45|700~REF|6R|10466026773Z10~SVC|HC^G0299|700|0|0551|0~DTM|472|20250820~CAS|CO|45|700~REF|6R|10466026773Z11~CLP|1150-250826135611|1|14000.01|2088.96||MA|172978981|32|9~NM1|QC|1|ABEY|JANET||||MI|41159685~NM1|74|1|||P~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|41159685~REF|G1|1720007278~DTM|232|20250725~DTM|233|20250822~DTM|050|20250827~AMT|AU|14000.01~SVC|HC^1EA21|0|2088.96|0023~DTM|472|20250725~CAS|CO|45|-2131.59||253|42.63~REF|6R|10466261840Z1~AMT|B6|2131.59~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250725~CAS|CO|45|.01~REF|6R|10466261840Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250725~CAS|CO|45|700~REF|6R|10466261840Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20250729~CAS|CO|45|700~REF|6R|10466261840Z4~SVC|HC^G0152|700|0|0431|0~DTM|472|20250729~CAS|CO|45|700~REF|6R|10466261840Z5~SVC|HC^G0157|700|0|0421|0~DTM|472|20250731~CAS|CO|45|700~REF|6R|10466261840Z6~SVC|HC^G0299|700|0|0551|0~DTM|472|20250801~CAS|CO|45|700~REF|6R|10466261840Z7~SVC|HC^G0152|700|0|0431|0~DTM|472|20250805~CAS|CO|45|700~REF|6R|10466261840Z8~SVC|HC^G0157|700|0|0421|0~DTM|472|20250805~CAS|CO|45|700~REF|6R|10466261840Z9~SVC|HC^G0156|700|0|0571|0~DTM|472|20250805~CAS|CO|45|700~REF|6R|10466261840Z10~SVC|HC^G0157|700|0|0421|0~DTM|472|20250807~CAS|CO|45|700~REF|6R|10466261840Z11~SVC|HC^G0299|700|0|0551|0~DTM|472|20250808~CAS|CO|45|700~REF|6R|10466261840Z12~SVC|HC^G0156|700|0|0571|0~DTM|472|20250808~CAS|CO|45|700~REF|6R|10466261840Z13~SVC|HC^G0156|700|0|0571|0~DTM|472|20250811~CAS|CO|45|700~REF|6R|10466261840Z14~SVC|HC^G0157|700|0|0421|0~DTM|472|20250813~CAS|CO|45|700~REF|6R|10466261840Z15~SVC|HC^G0299|700|0|0551|0~DTM|472|20250815~CAS|CO|45|700~REF|6R|10466261840Z16~SVC|HC^G0152|700|0|0431|0~DTM|472|20250815~CAS|CO|45|700~REF|6R|10466261840Z17~SVC|HC^G0157|700|0|0421|0~DTM|472|20250815~CAS|CO|45|700~REF|6R|10466261840Z18~SVC|HC^G0156|700|0|0571|0~DTM|472|20250818~CAS|CO|45|700~REF|6R|10466261840Z19~SVC|HC^G0157|700|0|0421|0~DTM|472|20250820~CAS|CO|45|700~REF|6R|10466261840Z20~SVC|HC^G0157|700|0|0421|0~DTM|472|20250821~CAS|CO|45|700~REF|6R|10466261840Z21~SVC|HC^G0299|700|0|0551|0~DTM|472|20250822~CAS|CO|45|700~REF|6R|10466261840Z22~CLP|1150-250826133821|1|5600.01|2131.08||MA|172978979|32|9~NM1|QC|1|MERCILLIOTT|MITCHELL||||MI|46196101~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|46196101~REF|G1|1719982332~DTM|232|20250806~DTM|233|20250819~DTM|050|20250827~AMT|AU|5600.01~SVC|HC^1EB11|0|2131.08|0023~DTM|472|20250806~CAS|CO|45|-2174.57||253|43.49~REF|6R|10466194491Z1~AMT|B6|2174.57~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250806~CAS|CO|45|.01~REF|6R|10466194491Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250806~CAS|CO|45|700~REF|6R|10466194491Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20250806~CAS|CO|45|700~REF|6R|10466194491Z4~SVC|HC^G0151|700|0|0421|0~DTM|472|20250807~CAS|CO|45|700~REF|6R|10466194491Z5~SVC|HC^G0151|700|0|0421|0~DTM|472|20250811~CAS|CO|45|700~REF|6R|10466194491Z6~SVC|HC^G0151|700|0|0421|0~DTM|472|20250812~CAS|CO|45|700~REF|6R|10466194491Z7~SVC|HC^G0299|700|0|0551|0~DTM|472|20250812~CAS|CO|45|700~REF|6R|10466194491Z8~SVC|HC^G0151|700|0|0421|0~DTM|472|20250814~CAS|CO|45|700~REF|6R|10466194491Z9~SVC|HC^G0151|700|0|0421|0~DTM|472|20250819~CAS|CO|45|700~REF|6R|10466194491Z10~CLP|1150-250826131924|1|7700.01|2418.37||MA|172978978|32|9~NM1|QC|1|TYLER|JAYNE||||MI|54215010~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|54215010~REF|G1|1720000402~DTM|232|20250723~DTM|233|20250821~DTM|050|20250827~AMT|AU|7700.01~SVC|HC^1EC11|0|2418.37|0023~DTM|472|20250723~CAS|CO|45|-2467.72||253|49.35~REF|6R|10466161360Z1~AMT|B6|2467.72~SVC|HC^Q5001|.01|0|0421|0~DTM|472|20250723~CAS|CO|45|.01~REF|6R|10466161360Z2~SVC|HC^G0151|700|0|0421|0~DTM|472|20250723~CAS|CO|45|700~REF|6R|10466161360Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20250728~CAS|CO|45|700~REF|6R|10466161360Z4~SVC|HC^G0151|700|0|0421|0~DTM|472|20250731~CAS|CO|45|700~REF|6R|10466161360Z5~SVC|HC^G0152|700|0|0431|0~DTM|472|20250804~CAS|CO|45|700~REF|6R|10466161360Z6~SVC|HC^G0151|700|0|0421|0~DTM|472|20250805~CAS|CO|45|700~REF|6R|10466161360Z7~SVC|HC^G0151|700|0|0421|0~DTM|472|20250808~CAS|CO|45|700~REF|6R|10466161360Z8~SVC|HC^G0151|700|0|0421|0~DTM|472|20250811~CAS|CO|45|700~REF|6R|10466161360Z9~SVC|HC^G0152|700|0|0431|0~DTM|472|20250811~CAS|CO|45|700~REF|6R|10466161360Z10~SVC|HC^G0151|700|0|0421|0~DTM|472|20250813~CAS|CO|45|700~REF|6R|10466161360Z11~SVC|HC^G0152|700|0|0431|0~DTM|472|20250818~CAS|CO|45|700~REF|6R|10466161360Z12~SVC|HC^G0151|700|0|0421|0~DTM|472|20250821~CAS|CO|45|700~REF|6R|10466161360Z13~SE|378|0001~GE|1|3418~IEA|1|000003418~