ISA|00|          |00|          |ZZ|ZIRMED         |ZZ|923001C9807506 |251028|2204|}|00501|000003451|0|P|^~GS|HP|ZIRMED|923001C9807506|20251028|2204|3451|X|005010X221A1~ST|835|0001~BPR|I|39785.4|C|ACH|CCP|01|031100209|DA|38876542|1520954463||01|055002338|DA|93128821|20251028~TRN|1|000001850781221|1520954463~DTM|405|20251028~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|1150-251021145059|1|5600.01|2088.96||MA|176632171|32|9~NM1|QC|1|LOGAN|BETTIE||||MI|241287844~NM1|74|1|||D~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|241287844~REF|G1|1720021178~DTM|232|20250820~DTM|233|20250904~DTM|050|20251022~AMT|AU|5600.01~SVC|HC^1EA21|0|2088.96|0023~DTM|472|20250820~CAS|CO|45|-2131.59||253|42.63~REF|6R|10783977371Z1~AMT|B6|2131.59~LQ|HE|N669~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250820~CAS|CO|45|.01~REF|6R|10783977371Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250820~CAS|CO|45|700~REF|6R|10783977371Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20250821~CAS|CO|45|700~REF|6R|10783977371Z4~SVC|HC^G0151|700|0|0421|0~DTM|472|20250822~CAS|CO|45|700~REF|6R|10783977371Z5~SVC|HC^G0299|700|0|0551|0~DTM|472|20250825~CAS|CO|45|700~REF|6R|10783977371Z6~SVC|HC^G0151|700|0|0421|0~DTM|472|20250828~CAS|CO|45|700~REF|6R|10783977371Z7~SVC|HC^G0151|700|0|0421|0~DTM|472|20250829~CAS|CO|45|700~REF|6R|10783977371Z8~SVC|HC^G0151|700|0|0421|0~DTM|472|20250902~CAS|CO|45|700~REF|6R|10783977371Z9~SVC|HC^G0151|700|0|0421|0~DTM|472|20250904~CAS|CO|45|700~REF|6R|10783977371Z10~CLP|1150-251021182316|1|2100.01|1282.76||MA|176632185|32|9~NM1|QC|1|SCHIELD|JOSEPH||||MI|421282542~NM1|74|1|||E~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|421282542~REF|G1|1720105902~DTM|232|20250930~DTM|233|20251014~DTM|050|20251022~AMT|AU|2100.01~SVC|HC^3HA21|0|1282.76|0023~DTM|472|20250930~CAS|CO|45|-1308.94||253|26.18~REF|6R|10784990904Z1~AMT|B6|1308.94~LQ|HE|N669~SVC|HC^Q5001|.01|0|0421|0~DTM|472|20250930~CAS|CO|45|.01~REF|6R|10784990904Z2~SVC|HC^G0151|700|0|0421|0~DTM|472|20250930~CAS|CO|45|700~REF|6R|10784990904Z3~SVC|HC^G0157|700|0|0421|0~DTM|472|20251007~CAS|CO|45|700~REF|6R|10784990904Z4~SVC|HC^G0151|700|0|0421|0~DTM|472|20251014~CAS|CO|45|700~REF|6R|10784990904Z5~CLP|1150-251021153426|1|6300.01|1961.32||MA|176632181|32|9~NM1|QC|1|NOONAN|RANDY||||MI|611287921~NM1|74|1|||P~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|611287921~REF|G1|1720163432~DTM|232|20250920~DTM|233|20251016~DTM|050|20251022~AMT|AU|6300.01~SVC|HC^1GA21|0|1961.32|0023~DTM|472|20250920~CAS|CO|45|-2001.35||253|40.03~REF|6R|10784196720Z1~AMT|B6|2001.35~LQ|HE|N669~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250920~CAS|CO|45|.01~REF|6R|10784196720Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250920~CAS|CO|45|700~REF|6R|10784196720Z3~SVC|HC^G0299|700|0|0551|0~DTM|472|20250923~CAS|CO|45|700~REF|6R|10784196720Z4~SVC|HC^G0151|700|0|0421|0~DTM|472|20250925~CAS|CO|45|700~REF|6R|10784196720Z5~SVC|HC^G0299|700|0|0551|0~DTM|472|20251001~CAS|CO|45|700~REF|6R|10784196720Z6~SVC|HC^G0299|700|0|0551|0~DTM|472|20251007~CAS|CO|45|700~REF|6R|10784196720Z7~SVC|HC^G0157|700|0|0421|0~DTM|472|20251007~CAS|CO|45|700~REF|6R|10784196720Z8~SVC|HC^G0299|700|0|0551|0~DTM|472|20251014~CAS|CO|45|700~REF|6R|10784196720Z9~SVC|HC^G0157|700|0|0421|0~DTM|472|20251014~CAS|CO|45|700~REF|6R|10784196720Z10~SVC|HC^G0157|700|0|0421|0~DTM|472|20251016~CAS|CO|45|700~REF|6R|10784196720Z11~CLP|1150-251021175233|1|4200.01|1245.78||MA|176632182|32|9~NM1|QC|1|PASCHALL BROWN|TYRENE||||MI|671072992~NM1|74|1|||L~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|671072992~REF|G1|1720050033~DTM|232|20250910~DTM|233|20251003~DTM|050|20251022~AMT|AU|4200.01~SVC|HC^3GA21|0|1245.78|0023~DTM|472|20250910~CAS|CO|45|-1271.2||253|25.42~REF|6R|10784956887Z1~AMT|B6|1271.2~LQ|HE|N669~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250910~CAS|CO|45|.01~REF|6R|10784956887Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250910~CAS|CO|45|700~REF|6R|10784956887Z3~SVC|HC^G0152|700|0|0431|0~DTM|472|20250910~CAS|CO|45|700~REF|6R|10784956887Z4~SVC|HC^G0299|700|0|0551|0~DTM|472|20250915~CAS|CO|45|700~REF|6R|10784956887Z5~SVC|HC^G0157|700|0|0421|0~DTM|472|20250915~CAS|CO|45|700~REF|6R|10784956887Z6~SVC|HC^G0152|700|0|0431|0~DTM|472|20250915~CAS|CO|45|700~REF|6R|10784956887Z7~SVC|HC^G0299|700|0|0551|0~DTM|472|20251003~CAS|CO|45|700~REF|6R|10784956887Z8~CLP|1150-251021131443|1|9100.01|3075.57||MA|176632155|32|9~NM1|QC|1|FUGATE|GEORGE||||MI|961133423~NM1|74|1|||L~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|961133423~REF|G1|1720152617~DTM|232|20250916~DTM|233|20251014~DTM|050|20251022~AMT|AU|9100.01~SVC|HC^1CA31|0|3075.57|0023~DTM|472|20250916~CAS|CO|45|-3138.34||253|62.77~REF|6R|10783506262Z1~AMT|B6|3138.34~LQ|HE|N669~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250916~CAS|CO|45|.01~REF|6R|10783506262Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250916~CAS|CO|45|700~REF|6R|10783506262Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20250923~CAS|CO|45|700~REF|6R|10783506262Z4~SVC|HC^G0299|700|0|0551|0~DTM|472|20250924~CAS|CO|45|700~REF|6R|10783506262Z5~SVC|HC^G0151|700|0|0421|0~DTM|472|20250925~CAS|CO|45|700~REF|6R|10783506262Z6~SVC|HC^G0299|700|0|0551|0~DTM|472|20250926~CAS|CO|45|700~REF|6R|10783506262Z7~SVC|HC^G0299|700|0|0551|0~DTM|472|20250929~CAS|CO|45|700~REF|6R|10783506262Z8~SVC|HC^G0151|700|0|0421|0~DTM|472|20250930~CAS|CO|45|700~REF|6R|10783506262Z9~SVC|HC^G0157|700|0|0421|0~DTM|472|20251003~CAS|CO|45|700~REF|6R|10783506262Z10~SVC|HC^G0299|700|0|0551|0~DTM|472|20251006~CAS|CO|45|700~REF|6R|10783506262Z11~SVC|HC^G0157|700|0|0421|0~DTM|472|20251007~CAS|CO|45|700~REF|6R|10783506262Z12~SVC|HC^G0157|700|0|0421|0~DTM|472|20251009~CAS|CO|45|700~REF|6R|10783506262Z13~SVC|HC^G0299|700|0|0551|0~DTM|472|20251013~CAS|CO|45|700~REF|6R|10783506262Z14~SVC|HC^G0157|700|0|0421|0~DTM|472|20251014~CAS|CO|45|700~REF|6R|10783506262Z15~CLP|1150-251021135439|1|2100.01|1552.37||MA|176632166|32|9~NM1|QC|1|JOHNSON|JAN||||MI|01196608~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|01196608~REF|G1|1720084981~DTM|232|20250923~DTM|233|20251010~DTM|050|20251022~AMT|AU|2100.01~SVC|HC^3BA21|0|1552.37|0023~DTM|472|20250923~CAS|CO|45|-1584.05||253|31.68~REF|6R|10783711864Z1~AMT|B6|1584.05~LQ|HE|N669~SVC|HC^Q5001|.01|0|0421|0~DTM|472|20250923~CAS|CO|45|.01~REF|6R|10783711864Z2~SVC|HC^G0151|700|0|0421|0~DTM|472|20250923~CAS|CO|45|700~REF|6R|10783711864Z3~SVC|HC^G0152|700|0|0431|0~DTM|472|20250926~CAS|CO|45|700~REF|6R|10783711864Z4~SVC|HC^G0152|700|0|0431|0~DTM|472|20251010~CAS|CO|45|700~REF|6R|10783711864Z5~CLP|1150-251021134640|1|700.01|296.76||MA|176632164|32|9~NM1|QC|1|GREENE|DONALD||||MI|19231581~NM1|74|1|||W~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|19231581~REF|G1|1720177368~DTM|232|20250924~DTM|233|20250924~DTM|050|20251022~AMT|AU|700.01~SVC|HC^1KC21|0|296.76|0023~DTM|472|20250924~CAS|CO|45|-302.82||253|6.06~REF|6R|10783682596Z1~AMT|B6|302.82~LQ|HE|N669~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250924~CAS|CO|45|.01~REF|6R|10783682596Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250924~CAS|CO|45|700~REF|6R|10783682596Z3~CLP|1150-251021182658|1|5600.01|2131.08||MA|176632190|32|9~NM1|QC|1|SCOTT|DEAN||||MI|32301366~NM1|74|1|||T~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|32301366~REF|G1|1720142309~DTM|232|20251002~DTM|233|20251016~DTM|050|20251022~AMT|AU|5600.01~SVC|HC^1EB11|0|2131.08|0023~DTM|472|20251002~CAS|CO|45|-2174.57||253|43.49~REF|6R|10784998425Z1~AMT|B6|2174.57~LQ|HE|N669~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20251002~CAS|CO|45|.01~REF|6R|10784998425Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20251002~CAS|CO|45|700~REF|6R|10784998425Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20251002~CAS|CO|45|700~REF|6R|10784998425Z4~SVC|HC^G0151|700|0|0421|0~DTM|472|20251006~CAS|CO|45|700~REF|6R|10784998425Z5~SVC|HC^G0299|700|0|0551|0~DTM|472|20251008~CAS|CO|45|700~REF|6R|10784998425Z6~SVC|HC^G0151|700|0|0421|0~DTM|472|20251008~CAS|CO|45|700~REF|6R|10784998425Z7~SVC|HC^G0151|700|0|0421|0~DTM|472|20251010~CAS|CO|45|700~REF|6R|10784998425Z8~SVC|HC^G0151|700|0|0421|0~DTM|472|20251013~CAS|CO|45|700~REF|6R|10784998425Z9~SVC|HC^G0151|700|0|0421|0~DTM|472|20251016~CAS|CO|45|700~REF|6R|10784998425Z10~CLP|1150-251021132802|1|2800.01|1543.55||MA|176632162|32|9~NM1|QC|1|JACKMAN|RONALD||||MI|14303574~NM1|74|1|||J~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|14303574~REF|G1|1720086054~DTM|232|20250930~DTM|233|20251009~DTM|050|20251022~AMT|AU|2800.01~SVC|HC^3EB21|0|1543.55|0023~DTM|472|20250930~CAS|CO|45|-1575.05||253|31.5~REF|6R|10783578622Z1~AMT|B6|1575.05~LQ|HE|N669~SVC|HC^Q5001|.01|0|0421|0~DTM|472|20250930~CAS|CO|45|.01~REF|6R|10783578622Z2~SVC|HC^G0151|700|0|0421|0~DTM|472|20250930~CAS|CO|45|700~REF|6R|10783578622Z3~SVC|HC^G0299|700|0|0551|0~DTM|472|20251002~CAS|CO|45|700~REF|6R|10783578622Z4~SVC|HC^G0152|700|0|0431|0~DTM|472|20251002~CAS|CO|45|700~REF|6R|10783578622Z5~SVC|HC^G0152|700|0|0431|0~DTM|472|20251009~CAS|CO|45|700~REF|6R|10783578622Z6~CLP|1150-251021132159|1|5600.01|2546.2||MA|176632159|32|9~NM1|QC|1|ISBELL|GENEVIEVE||||MI|62308780~NM1|74|1|||M~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|62308780~REF|G1|1720142174~DTM|232|20251001~DTM|233|20251015~DTM|050|20251022~AMT|AU|5600.01~SVC|HC^1EC21|0|2546.2|0023~DTM|472|20251001~CAS|CO|45|-2598.16||253|51.96~REF|6R|10783532374Z1~AMT|B6|2598.16~LQ|HE|N669~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20251001~CAS|CO|45|.01~REF|6R|10783532374Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20251001~CAS|CO|45|700~REF|6R|10783532374Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20251001~CAS|CO|45|700~REF|6R|10783532374Z4~SVC|HC^G0151|700|0|0421|0~DTM|472|20251006~CAS|CO|45|700~REF|6R|10783532374Z5~SVC|HC^G0299|700|0|0551|0~DTM|472|20251007~CAS|CO|45|700~REF|6R|10783532374Z6~SVC|HC^G0151|700|0|0421|0~DTM|472|20251008~CAS|CO|45|700~REF|6R|10783532374Z7~SVC|HC^G0151|700|0|0421|0~DTM|472|20251010~CAS|CO|45|700~REF|6R|10783532374Z8~SVC|HC^G0151|700|0|0421|0~DTM|472|20251013~CAS|CO|45|700~REF|6R|10783532374Z9~SVC|HC^G0151|700|0|0421|0~DTM|472|20251015~CAS|CO|45|700~REF|6R|10783532374Z10~CLP|1150-251021130756|1|4900.01|2015.78||MA|176632153|32|9~NM1|QC|1|FRAZIER|DOLLIE||||MI|24309055~NM1|74|1|||L~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|24309055~REF|G1|1720161168~DTM|232|20250919~DTM|233|20251017~DTM|050|20251022~AMT|AU|4900.01~SVC|HC^1LA21|0|2015.78|0023~DTM|472|20250919~CAS|CO|45|-2056.92||253|41.14~REF|6R|10783424511Z1~AMT|B6|2056.92~LQ|HE|N669~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250919~CAS|CO|45|.01~REF|6R|10783424511Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250919~CAS|CO|45|700~REF|6R|10783424511Z3~SVC|HC^G0152|700|0|0431|0~DTM|472|20250922~CAS|CO|45|700~REF|6R|10783424511Z4~SVC|HC^G0299|700|0|0551|0~DTM|472|20250924~CAS|CO|45|700~REF|6R|10783424511Z5~SVC|HC^G0151|700|0|0421|0~DTM|472|20250929~CAS|CO|45|700~REF|6R|10783424511Z6~SVC|HC^G0152|700|0|0431|0~DTM|472|20251006~CAS|CO|45|700~REF|6R|10783424511Z7~SVC|HC^G0157|700|0|0421|0~DTM|472|20251006~CAS|CO|45|700~REF|6R|10783424511Z8~SVC|HC^G0157|700|0|0421|0~DTM|472|20251017~CAS|CO|45|700~REF|6R|10783424511Z9~CLP|1150-251021125917|1|4200.01|1998.32||MA|176632151|32|9~NM1|QC|1|FOWLKES|RICARDO||||MI|51309748~NM1|74|1|||L~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|51309748~REF|G1|1720157603~DTM|232|20250918~DTM|233|20251014~DTM|050|20251022~AMT|AU|4200.01~SVC|HC^1HA21|0|1998.32|0023~DTM|472|20250918~CAS|CO|45|-2039.1||253|40.78~REF|6R|10783360329Z1~AMT|B6|2039.1~LQ|HE|N669~SVC|HC^Q5001|.01|0|0421|0~DTM|472|20250918~CAS|CO|45|.01~REF|6R|10783360329Z2~SVC|HC^G0151|700|0|0421|0~DTM|472|20250918~CAS|CO|45|700~REF|6R|10783360329Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20250925~CAS|CO|45|700~REF|6R|10783360329Z4~SVC|HC^G0152|700|0|0431|0~DTM|472|20251006~CAS|CO|45|700~REF|6R|10783360329Z5~SVC|HC^G0151|700|0|0421|0~DTM|472|20251007~CAS|CO|45|700~REF|6R|10783360329Z6~SVC|HC^G0151|700|0|0421|0~DTM|472|20251014~CAS|CO|45|700~REF|6R|10783360329Z7~SVC|HC^G0152|700|0|0431|0~DTM|472|20251014~CAS|CO|45|700~REF|6R|10783360329Z8~CLP|1150-251021181930|1|4900.01|2360.01||MA|176632184|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|20250922~DTM|233|20251015~DTM|050|20251022~AMT|AU|4900.01~SVC|HC^3CA31|0|2360.01|0023~DTM|472|20250922~CAS|CO|45|-2408.17||253|48.16~REF|6R|10784980868Z1~AMT|B6|2408.17~LQ|HE|N669~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250922~CAS|CO|45|.01~REF|6R|10784980868Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250922~CAS|CO|45|700~REF|6R|10784980868Z3~SVC|HC^G0299|700|0|0551|0~DTM|472|20250924~CAS|CO|45|700~REF|6R|10784980868Z4~SVC|HC^G0299|700|0|0551|0~DTM|472|20250929~CAS|CO|45|700~REF|6R|10784980868Z5~SVC|HC^G0299|700|0|0551|0~DTM|472|20251007~CAS|CO|45|700~REF|6R|10784980868Z6~SVC|HC^G0299|700|0|0551|0~DTM|472|20251009~CAS|CO|45|700~REF|6R|10784980868Z7~SVC|HC^G0299|700|0|0551|0~DTM|472|20251013~CAS|CO|45|700~REF|6R|10784980868Z8~SVC|HC^G0299|700|0|0551|0~DTM|472|20251015~CAS|CO|45|700~REF|6R|10784980868Z9~CLP|1150-251021141751|1|5600.01|1282.76||MA|176632170|32|9~NM1|QC|1|JOHNSON|TONY||||MI|41312215~NM1|74|1|||T~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|41312215~REF|G1|1720076587~DTM|232|20250922~DTM|233|20251013~DTM|050|20251022~AMT|AU|5600.01~SVC|HC^3HA21|0|1282.76|0023~DTM|472|20250922~CAS|CO|45|-1308.94||253|26.18~REF|6R|10783843094Z1~AMT|B6|1308.94~LQ|HE|N669~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250922~CAS|CO|45|.01~REF|6R|10783843094Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250922~CAS|CO|45|700~REF|6R|10783843094Z3~SVC|HC^G0152|700|0|0431|0~DTM|472|20250922~CAS|CO|45|700~REF|6R|10783843094Z4~SVC|HC^G0157|700|0|0421|0~DTM|472|20250925~CAS|CO|45|700~REF|6R|10783843094Z5~SVC|HC^G0151|700|0|0421|0~DTM|472|20250930~CAS|CO|45|700~REF|6R|10783843094Z6~SVC|HC^G0152|700|0|0431|0~DTM|472|20250930~CAS|CO|45|700~REF|6R|10783843094Z7~SVC|HC^G0299|700|0|0551|0~DTM|472|20251001~CAS|CO|45|700~REF|6R|10783843094Z8~SVC|HC^G0152|700|0|0431|0~DTM|472|20251006~CAS|CO|45|700~REF|6R|10783843094Z9~SVC|HC^G0152|700|0|0431|0~DTM|472|20251013~CAS|CO|45|700~REF|6R|10783843094Z10~CLP|1150-251021123841|1|3500.01|1373.38||MA|176632143|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|1720007279~DTM|232|20250826~DTM|233|20250918~DTM|050|20251022~AMT|AU|3500.01~SVC|HC^3EA21|0|1373.38|0023~DTM|472|20250826~CAS|CO|45|-1401.41||253|28.03~REF|6R|10783281068Z1~AMT|B6|1401.41~LQ|HE|N669~SVC|HC^Q5001|.01|0|0421|0~DTM|472|20250826~CAS|CO|45|.01~REF|6R|10783281068Z2~SVC|HC^G0151|700|0|0421|0~DTM|472|20250826~CAS|CO|45|700~REF|6R|10783281068Z3~SVC|HC^G0299|700|0|0551|0~DTM|472|20250829~CAS|CO|45|700~REF|6R|10783281068Z4~SVC|HC^G0157|700|0|0421|0~DTM|472|20250902~CAS|CO|45|700~REF|6R|10783281068Z5~SVC|HC^G0157|700|0|0421|0~DTM|472|20250910~CAS|CO|45|700~REF|6R|10783281068Z6~SVC|HC^G0151|700|0|0421|0~DTM|472|20250918~CAS|CO|45|700~REF|6R|10783281068Z7~CLP|1150-251021124330|1|5600.01|1373.38||MA|176632144|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|1720007281~DTM|232|20250924~DTM|233|20251016~DTM|050|20251022~AMT|AU|5600.01~SVC|HC^3EA21|0|1373.38|0023~DTM|472|20250924~CAS|CO|45|-1401.41||253|28.03~REF|6R|10783297917Z1~AMT|B6|1401.41~LQ|HE|N669~SVC|HC^Q5001|.01|0|0421|0~DTM|472|20250924~CAS|CO|45|.01~REF|6R|10783297917Z2~SVC|HC^G0157|700|0|0421|0~DTM|472|20250924~CAS|CO|45|700~REF|6R|10783297917Z3~SVC|HC^G0157|700|0|0421|0~DTM|472|20250926~CAS|CO|45|700~REF|6R|10783297917Z4~SVC|HC^G0157|700|0|0421|0~DTM|472|20251001~CAS|CO|45|700~REF|6R|10783297917Z5~SVC|HC^G0157|700|0|0421|0~DTM|472|20251003~CAS|CO|45|700~REF|6R|10783297917Z6~SVC|HC^G0157|700|0|0421|0~DTM|472|20251007~CAS|CO|45|700~REF|6R|10783297917Z7~SVC|HC^G0157|700|0|0421|0~DTM|472|20251009~CAS|CO|45|700~REF|6R|10783297917Z8~SVC|HC^G0157|700|0|0421|0~DTM|472|20251014~CAS|CO|45|700~REF|6R|10783297917Z9~SVC|HC^G0151|700|0|0421|0~DTM|472|20251016~CAS|CO|45|700~REF|6R|10783297917Z10~CLP|1150-251021151208|1|4900.01|2360.01||MA|176632177|32|9~NM1|QC|1|MAUZONE|JUANITA||||MI|17166781~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|17166781~REF|G1|1719990232~DTM|232|20250923~DTM|233|20251016~DTM|050|20251022~AMT|AU|4900.01~SVC|HC^3CA31|0|2360.01|0023~DTM|472|20250923~CAS|CO|45|-2408.17||253|48.16~REF|6R|10784109773Z1~AMT|B6|2408.17~LQ|HE|N669~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250923~CAS|CO|45|.01~REF|6R|10784109773Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250923~CAS|CO|45|700~REF|6R|10784109773Z3~SVC|HC^G0299|700|0|0551|0~DTM|472|20250925~CAS|CO|45|700~REF|6R|10784109773Z4~SVC|HC^G0299|700|0|0551|0~DTM|472|20250930~CAS|CO|45|700~REF|6R|10784109773Z5~SVC|HC^G0299|700|0|0551|0~DTM|472|20251007~CAS|CO|45|700~REF|6R|10784109773Z6~SVC|HC^G0299|700|0|0551|0~DTM|472|20251009~CAS|CO|45|700~REF|6R|10784109773Z7~SVC|HC^G0299|700|0|0551|0~DTM|472|20251014~CAS|CO|45|700~REF|6R|10784109773Z8~SVC|HC^G0299|700|0|0551|0~DTM|472|20251016~CAS|CO|45|700~REF|6R|10784109773Z9~CLP|1150-251021163836|1|5600.01|1961.32||MA|176630704|32|9~NM1|QC|1|QAWIYY|LILLIAN||||MI|95179069~NM1|74|1||LILIAN|S|||C|85179069~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|85179069~REF|G1|1720119332~DTM|232|20250904~DTM|233|20251003~DTM|050|20251022~AMT|AU|5600.01~SVC|HC^1GA21|0|1961.32|0023~DTM|472|20250904~CAS|CO|45|-2001.35||253|40.03~REF|6R|10784705823Z1~AMT|B6|2001.35~LQ|HE|N669~SVC|HC^Q5001|.01|0|0421|0~DTM|472|20250904~CAS|CO|45|.01~REF|6R|10784705823Z2~SVC|HC^G0151|700|0|0421|0~DTM|472|20250904~CAS|CO|45|700~REF|6R|10784705823Z3~SVC|HC^G0152|700|0|0431|0~DTM|472|20250908~CAS|CO|45|700~REF|6R|10784705823Z4~SVC|HC^G0152|700|0|0431|0~DTM|472|20250915~CAS|CO|45|700~REF|6R|10784705823Z5~SVC|HC^G0157|700|0|0421|0~DTM|472|20250918~CAS|CO|45|700~REF|6R|10784705823Z6~SVC|HC^G0152|700|0|0431|0~DTM|472|20250922~CAS|CO|45|700~REF|6R|10784705823Z7~SVC|HC^G0157|700|0|0421|0~DTM|472|20250923~CAS|CO|45|700~REF|6R|10784705823Z8~SVC|HC^G0152|700|0|0431|0~DTM|472|20250929~CAS|CO|45|700~REF|6R|10784705823Z9~SVC|HC^G0151|700|0|0421|0~DTM|472|20251003~CAS|CO|45|700~REF|6R|10784705823Z10~CLP|1150-251021164015|1|1400.01|1245.78||MA|176630712|32|9~NM1|QC|1|QAWIYY|LILLIAN||||MI|95179069~NM1|74|1||LILIAN|S|||C|85179069~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|85179069~REF|G1|1720119333~DTM|232|20251006~DTM|233|20251013~DTM|050|20251022~AMT|AU|1400.01~SVC|HC^3GA21|0|1245.78|0023~DTM|472|20251006~CAS|CO|45|-1271.2||253|25.42~REF|6R|10784708312Z1~AMT|B6|1271.2~LQ|HE|N669~SVC|HC^Q5001|.01|0|0431|0~DTM|472|20251006~CAS|CO|45|.01~REF|6R|10784708312Z2~SVC|HC^G0152|700|0|0431|0~DTM|472|20251006~CAS|CO|45|700~REF|6R|10784708312Z3~SVC|HC^G0152|700|0|0431|0~DTM|472|20251013~CAS|CO|45|700~REF|6R|10784708312Z4~CLP|1150-251021125016|1|5600.01|2258.9||MA|176632149|32|9~NM1|QC|1|CRANDELL|ROBERT||||MI|77197165~NM1|74|1|||D~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|77197165~REF|G1|1720134490~DTM|232|20250930~DTM|233|20251013~DTM|050|20251022~AMT|AU|5600.01~SVC|HC^1EB21|0|2258.9|0023~DTM|472|20250930~CAS|CO|45|-2305||253|46.1~REF|6R|10783337773Z1~AMT|B6|2305~LQ|HE|N669~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250930~CAS|CO|45|.01~REF|6R|10783337773Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250930~CAS|CO|45|700~REF|6R|10783337773Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20250930~CAS|CO|45|700~REF|6R|10783337773Z4~SVC|HC^G0151|700|0|0421|0~DTM|472|20251002~CAS|CO|45|700~REF|6R|10783337773Z5~SVC|HC^G0151|700|0|0421|0~DTM|472|20251006~CAS|CO|45|700~REF|6R|10783337773Z6~SVC|HC^G0299|700|0|0551|0~DTM|472|20251006~CAS|CO|45|700~REF|6R|10783337773Z7~SVC|HC^G0151|700|0|0421|0~DTM|472|20251008~CAS|CO|45|700~REF|6R|10783337773Z8~SVC|HC^G0151|700|0|0421|0~DTM|472|20251010~CAS|CO|45|700~REF|6R|10783337773Z9~SVC|HC^G0151|700|0|0421|0~DTM|472|20251013~CAS|CO|45|700~REF|6R|10783337773Z10~CLP|1150-251021150025|1|4200.01|1700.33||MA|176632174|32|9~NM1|QC|1|LOVE|JACK||||MI|42215273~NM1|74|1|||R~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|42215273~REF|G1|1719936904~DTM|232|20250924~DTM|233|20251015~DTM|050|20251022~AMT|AU|4200.01~SVC|HC^3HC21|0|1700.33|0023~DTM|472|20250924~CAS|CO|45|-1735.03||253|34.7~REF|6R|10784055225Z1~AMT|B6|1735.03~LQ|HE|N669~SVC|HC^Q5001|.01|0|0421|0~DTM|472|20250924~CAS|CO|45|.01~REF|6R|10784055225Z2~SVC|HC^G0151|700|0|0421|0~DTM|472|20250924~CAS|CO|45|700~REF|6R|10784055225Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20250926~CAS|CO|45|700~REF|6R|10784055225Z4~SVC|HC^G0151|700|0|0421|0~DTM|472|20251001~CAS|CO|45|700~REF|6R|10784055225Z5~SVC|HC^G0151|700|0|0421|0~DTM|472|20251003~CAS|CO|45|700~REF|6R|10784055225Z6~SVC|HC^G0151|700|0|0421|0~DTM|472|20251010~CAS|CO|45|700~REF|6R|10784055225Z7~SVC|HC^G0151|700|0|0421|0~DTM|472|20251015~CAS|CO|45|700~REF|6R|10784055225Z8~CLP|1150-251021151858|1|5600.01|2131.08||MA|176632180|32|9~NM1|QC|1|MCGONIGAL|MICHAEL||||MI|84218234~NM1|74|1|||L~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|84218234~REF|G1|1720134457~DTM|232|20250926~DTM|233|20251008~DTM|050|20251022~AMT|AU|5600.01~SVC|HC^1EB11|0|2131.08|0023~DTM|472|20250926~CAS|CO|45|-2174.57||253|43.49~REF|6R|10784129157Z1~AMT|B6|2174.57~LQ|HE|N669~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250926~CAS|CO|45|.01~REF|6R|10784129157Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250926~CAS|CO|45|700~REF|6R|10784129157Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20250926~CAS|CO|45|700~REF|6R|10784129157Z4~SVC|HC^G0151|700|0|0421|0~DTM|472|20250929~CAS|CO|45|700~REF|6R|10784129157Z5~SVC|HC^G0151|700|0|0421|0~DTM|472|20251001~CAS|CO|45|700~REF|6R|10784129157Z6~SVC|HC^G0299|700|0|0551|0~DTM|472|20251002~CAS|CO|45|700~REF|6R|10784129157Z7~SVC|HC^G0151|700|0|0421|0~DTM|472|20251003~CAS|CO|45|700~REF|6R|10784129157Z8~SVC|HC^G0151|700|0|0421|0~DTM|472|20251006~CAS|CO|45|700~REF|6R|10784129157Z9~SVC|HC^G0151|700|0|0421|0~DTM|472|20251008~CAS|CO|45|700~REF|6R|10784129157Z10~SE|1024|0001~GE|1|3451~IEA|1|000003451~