ISA|00| |00| |ZZ|ZIRMED |ZZ|923001C9807506 |251003|2259|}|00501|000003437|0|P|^~GS|HP|ZIRMED|923001C9807506|20251003|2259|3437|X|005010X221A1~ST|835|0001~BPR|I|4690.2|C|ACH|CCP|01|031100209|DA|38876542|1520954463||01|055002338|DA|93128821|20251003~TRN|1|000001850773201|1520954463~DTM|405|20251003~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|1150-250926144412|1|3500|675||HM|175116131|32|4~NM1|QC|1|HOLLOMAN|JADON||||MI|43121668~NM1|74|1|||D~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|43121668~REF|G1|1720108427~DTM|232|20250911~DTM|233|20250922~DTM|050|20250929~AMT|AU|3500~SVC|HC^G0151|700|139|0421~DTM|472|20250911~CAS|CO|45|561~REF|6R|10643516670Z1~AMT|B6|139~SVC|HC^G0299|700|119|0551~DTM|472|20250915~CAS|CO|45|581~REF|6R|10643516670Z2~AMT|B6|119~SVC|HC^G0151|700|139|0421~DTM|472|20250915~CAS|CO|45|561~REF|6R|10643516670Z3~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20250918~CAS|CO|45|561~REF|6R|10643516670Z4~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20250922~CAS|CO|45|561~REF|6R|10643516670Z5~AMT|B6|139~CLP|1150-250926142132|1|7700|1469||HM|175116130|32|2~NM1|QC|1|GAO|DIANZHONG||||MI|19234287~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|19234287~REF|G1|1720110857~DTM|232|20250903~DTM|233|20250919~DTM|050|20250929~AMT|AU|7700~SVC|HC^G0299|700|119|0551~DTM|472|20250903~CAS|CO|45|581~REF|6R|10643467320Z1~AMT|B6|119~SVC|HC^G0151|700|139|0421~DTM|472|20250904~CAS|CO|45|561~REF|6R|10643467320Z2~AMT|B6|139~SVC|HC^G0152|700|139|0431~DTM|472|20250905~CAS|CO|45|561~REF|6R|10643467320Z3~AMT|B6|139~SVC|HC^G0152|700|139|0431~DTM|472|20250908~CAS|CO|45|561~REF|6R|10643467320Z4~AMT|B6|139~SVC|HC^G0299|700|119|0551~DTM|472|20250910~CAS|CO|45|581~REF|6R|10643467320Z5~AMT|B6|119~SVC|HC^G0157|700|139|0421~DTM|472|20250910~CAS|CO|45|561~REF|6R|10643467320Z6~AMT|B6|139~SVC|HC^G0157|700|139|0421~DTM|472|20250911~CAS|CO|45|561~REF|6R|10643467320Z7~AMT|B6|139~SVC|HC^G0157|700|139|0421~DTM|472|20250915~CAS|CO|45|561~REF|6R|10643467320Z8~AMT|B6|139~SVC|HC^G0157|700|139|0421~DTM|472|20250917~CAS|CO|45|561~REF|6R|10643467320Z9~AMT|B6|139~SVC|HC^G0152|700|139|0431~DTM|472|20250918~CAS|CO|45|561~REF|6R|10643467320Z10~AMT|B6|139~SVC|HC^G0299|700|119|0551~DTM|472|20250919~CAS|CO|45|581~REF|6R|10643467320Z11~AMT|B6|119~CLP|1150-250926121816|1|4200.01|2546.2||MA|175116759|32|9~NM1|QC|1|LAWSON|AVA||||MI|21156172~NM1|74|1|||D~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|21156172~REF|G1|1720078170~DTM|232|20250909~DTM|233|20250918~DTM|050|20250929~AMT|AU|4200.01~SVC|HC^1EC21|0|2546.2|0023~DTM|472|20250909~CAS|CO|45|-2598.16||253|51.96~REF|6R|10642811256Z1~AMT|B6|2598.16~LQ|HE|N669~SVC|HC^Q5001|.01|0|0421|0~DTM|472|20250909~CAS|CO|45|.01~REF|6R|10642811256Z2~SVC|HC^G0151|700|0|0421|0~DTM|472|20250909~CAS|CO|45|700~REF|6R|10642811256Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20250910~CAS|CO|45|700~REF|6R|10642811256Z4~SVC|HC^G0151|700|0|0421|0~DTM|472|20250911~CAS|CO|45|700~REF|6R|10642811256Z5~SVC|HC^G0151|700|0|0421|0~DTM|472|20250915~CAS|CO|45|700~REF|6R|10642811256Z6~SVC|HC^G0151|700|0|0421|0~DTM|472|20250916~CAS|CO|45|700~REF|6R|10642811256Z7~SVC|HC^G0151|700|0|0421|0~DTM|472|20250918~CAS|CO|45|700~REF|6R|10642811256Z8~SE|158|0001~GE|1|3437~IEA|1|000003437~