ISA|00| |00| |ZZ|ZIRMED |ZZ|923001C9807506 |251029|2204|}|00501|000003452|0|P|^~GS|HP|ZIRMED|923001C9807506|20251029|2204|3452|X|005010X221A1~ST|835|0001~BPR|I|23233.73|C|ACH|CCP|01|031100209|DA|38876542|1520954463||01|055002338|DA|93128821|20251029~TRN|1|000001850781695|1520954463~DTM|405|20251029~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|1150-251022140337|1|5600|1072||15|176774222|32|1~NM1|QC|1|WASHINGTON|DORIS||||MI|72115260~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|72115260~REF|G1|1720134223~DTM|232|20250927~DTM|233|20251009~DTM|050|20251023~AMT|AU|5600~SVC|HC^G0299|700|119|0551~DTM|472|20250927~CAS|CO|45|581~REF|6R|10790604087Z1~AMT|B6|119~SVC|HC^G0151|700|139|0421~DTM|472|20250929~CAS|CO|45|561~REF|6R|10790604087Z2~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251001~CAS|CO|45|561~REF|6R|10790604087Z3~AMT|B6|139~SVC|HC^G0299|700|119|0551~DTM|472|20251002~CAS|CO|45|581~REF|6R|10790604087Z4~AMT|B6|119~SVC|HC^G0151|700|139|0421~DTM|472|20251003~CAS|CO|45|561~REF|6R|10790604087Z5~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251006~CAS|CO|45|561~REF|6R|10790604087Z6~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251007~CAS|CO|45|561~REF|6R|10790604087Z7~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251009~CAS|CO|45|561~REF|6R|10790604087Z8~AMT|B6|139~CLP|1150-251022135020|1|2800|536||HM|176774220|32|2~NM1|QC|1|VANN|WILBERT||||MI|77127067~NM1|74|1|||L~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|77127067~REF|G1|1720167129~DTM|232|20250925~DTM|233|20251016~DTM|050|20251023~AMT|AU|2800~SVC|HC^G0299|700|119|0551~DTM|472|20250925~CAS|CO|45|581~REF|6R|10790551012Z1~AMT|B6|119~SVC|HC^G0151|700|139|0421~DTM|472|20251002~CAS|CO|45|561~REF|6R|10790551012Z2~AMT|B6|139~SVC|HC^G0157|700|139|0421~DTM|472|20251007~CAS|CO|45|561~REF|6R|10790551012Z3~AMT|B6|139~SVC|HC^G0157|700|139|0421~DTM|472|20251016~CAS|CO|45|561~REF|6R|10790551012Z4~AMT|B6|139~CLP|1150-251022132748|1|1400|278||HM|176774218|32|1~NM1|QC|1|SEWELL|DONALD||||MI|88109796~NM1|74|1|SEWELL JR||A~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|88109796~REF|G1|1720195530~DTM|232|20251001~DTM|233|20251010~DTM|050|20251023~AMT|AU|1400~SVC|HC^G0151|700|139|0421~DTM|472|20251001~CAS|CO|45|561~REF|6R|10790450642Z1~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251010~CAS|CO|45|561~REF|6R|10790450642Z2~AMT|B6|139~CLP|1150-251022144308|1|5600|1317.88||HM|176774778|32|1~NM1|QC|1|FLOYD|MONICA||||MI|511043407~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|511043407~REF|G1|1720104775~DTM|232|20250917~DTM|233|20250929~DTM|050|20251023~AMT|AU|5600~SVC|HC^G0299|700|155.27|0551~DTM|472|20250917~CAS|CO|45|544.73~REF|6R|10790757415Z1~AMT|B6|155.27~SVC|HC^G0151|700|167.89|0421~DTM|472|20250917~CAS|CO|45|532.11~REF|6R|10790757415Z2~AMT|B6|167.89~SVC|HC^G0151|700|167.89|0421~DTM|472|20250919~CAS|CO|45|532.11~REF|6R|10790757415Z3~AMT|B6|167.89~SVC|HC^G0151|700|167.89|0421~DTM|472|20250922~CAS|CO|45|532.11~REF|6R|10790757415Z4~AMT|B6|167.89~SVC|HC^G0299|700|155.27|0551~DTM|472|20250923~CAS|CO|45|544.73~REF|6R|10790757415Z5~AMT|B6|155.27~SVC|HC^G0151|700|167.89|0421~DTM|472|20250924~CAS|CO|45|532.11~REF|6R|10790757415Z6~AMT|B6|167.89~SVC|HC^G0151|700|167.89|0421~DTM|472|20250926~CAS|CO|45|532.11~REF|6R|10790757415Z7~AMT|B6|167.89~SVC|HC^G0151|700|167.89|0421~DTM|472|20250929~CAS|CO|45|532.11~REF|6R|10790757415Z8~AMT|B6|167.89~CLP|1150-251022141011|1|1400|258||HM|176774226|32|1~NM1|QC|1|SOLIS|CHERYL||||MI|751004905~NM1|74|1|||L~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|751004905~REF|G1|1720183973~DTM|232|20250930~DTM|233|20250930~DTM|050|20251023~AMT|AU|1400~SVC|HC^G0299|700|119|0551~DTM|472|20250930~CAS|CO|45|581~REF|6R|10790627144Z1~AMT|B6|119~SVC|HC^G0151|700|139|0421~DTM|472|20250930~CAS|CO|45|561~REF|6R|10790627144Z2~AMT|B6|139~CLP|1150-251022130334|1|2800|516||HM|176774204|32|3~NM1|QC|1|MORRIS|AARON||||MI|881013188~NM1|74|1|||I~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|881013188~REF|G1|1720182415~DTM|232|20251008~DTM|233|20251015~DTM|050|20251023~AMT|AU|2800~SVC|HC^G0152|700|139|0431~DTM|472|20251008~CAS|CO|45|561~REF|6R|10790320388Z1~AMT|B6|139~SVC|HC^G0299|700|119|0551~DTM|472|20251011~CAS|CO|45|581~REF|6R|10790320388Z2~AMT|B6|119~SVC|HC^G0299|700|119|0551~DTM|472|20251015~CAS|CO|45|581~REF|6R|10790320388Z3~AMT|B6|119~SVC|HC^G0152|700|139|0431~DTM|472|20251015~CAS|CO|45|561~REF|6R|10790320388Z4~AMT|B6|139~CLP|1150-251022124144|1|4900|1162.61||HM|176774773|32|1~NM1|QC|1|HAWKINS|JOHN||||MI|981167819~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|981167819~REF|G1|1720118307~DTM|232|20250919~DTM|233|20251003~DTM|050|20251023~AMT|AU|4900~SVC|HC^G0299|700|155.27|0551~DTM|472|20250919~CAS|CO|45|544.73~REF|6R|10790244682Z1~AMT|B6|155.27~SVC|HC^G0151|700|167.89|0421~DTM|472|20250919~CAS|CO|45|532.11~REF|6R|10790244682Z2~AMT|B6|167.89~SVC|HC^G0151|700|167.89|0421~DTM|472|20250922~CAS|CO|45|532.11~REF|6R|10790244682Z3~AMT|B6|167.89~SVC|HC^G0151|700|167.89|0421~DTM|472|20250924~CAS|CO|45|532.11~REF|6R|10790244682Z4~AMT|B6|167.89~SVC|HC^G0151|700|167.89|0421~DTM|472|20250925~CAS|CO|45|532.11~REF|6R|10790244682Z5~AMT|B6|167.89~SVC|HC^G0151|700|167.89|0421~DTM|472|20250929~CAS|CO|45|532.11~REF|6R|10790244682Z6~AMT|B6|167.89~SVC|HC^G0151|700|167.89|0421~DTM|472|20251003~CAS|CO|45|532.11~REF|6R|10790244682Z7~AMT|B6|167.89~CLP|1150-251022151437|1|1400.01|469.3||MA|176775304|32|9~NM1|QC|1|KELLER|STEVEN||||MI|081148440~NM1|74|1|||M~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|081148440~REF|G1|1720153343~DTM|232|20250917~DTM|233|20250922~DTM|050|20251023~AMT|AU|1400.01~SVC|HC^1EA21|0|469.3|0023~DTM|472|20250917~CAS|CO|45|-478.88||253|9.58~REF|6R|10790915414Z1~AMT|B6|478.88~LQ|HE|N669~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250917~CAS|CO|45|.01~REF|6R|10790915414Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250917~CAS|CO|45|700~REF|6R|10790915414Z3~SVC|HC^G0299|700|0|0551|0~DTM|472|20250922~CAS|CO|45|700~REF|6R|10790915414Z4~CLP|1150-251022145114|1|5600|1317.88||HM|176774779|32|1~NM1|QC|1|OURAND|ROBERT||||MI|48224594~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|48224594~REF|G1|1720134290~DTM|232|20250930~DTM|233|20251009~DTM|050|20251023~AMT|AU|5600~SVC|HC^G0299|700|155.27|0551~DTM|472|20250930~CAS|CO|45|544.73~REF|6R|10790802143Z1~AMT|B6|155.27~SVC|HC^G0151|700|167.89|0421~DTM|472|20250930~CAS|CO|45|532.11~REF|6R|10790802143Z2~AMT|B6|167.89~SVC|HC^G0151|700|167.89|0421~DTM|472|20251001~CAS|CO|45|532.11~REF|6R|10790802143Z3~AMT|B6|167.89~SVC|HC^G0151|700|167.89|0421~DTM|472|20251002~CAS|CO|45|532.11~REF|6R|10790802143Z4~AMT|B6|167.89~SVC|HC^G0151|700|167.89|0421~DTM|472|20251006~CAS|CO|45|532.11~REF|6R|10790802143Z5~AMT|B6|167.89~SVC|HC^G0299|700|155.27|0551~DTM|472|20251006~CAS|CO|45|544.73~REF|6R|10790802143Z6~AMT|B6|155.27~SVC|HC^G0151|700|167.89|0421~DTM|472|20251007~CAS|CO|45|532.11~REF|6R|10790802143Z7~AMT|B6|167.89~SVC|HC^G0151|700|167.89|0421~DTM|472|20251009~CAS|CO|45|532.11~REF|6R|10790802143Z8~AMT|B6|167.89~CLP|1150-251022150431|1|4200|1014.58||HM|176774784|32|1~NM1|QC|1|THOMAS|ADRIENNE||||MI|57227943~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|57227943~REF|G1|1720178799~DTM|232|20250925~DTM|233|20251016~DTM|050|20251023~AMT|AU|4200~SVC|HC^G0151|700|167.89|0421~DTM|472|20250925~CAS|CO|45|532.11~REF|6R|10790870003Z1~AMT|B6|167.89~SVC|HC^G0151|700|167.89|0421~DTM|472|20250930~CAS|CO|45|532.11~REF|6R|10790870003Z2~AMT|B6|167.89~SVC|HC^G0152|700|171.51|0431~DTM|472|20251003~CAS|CO|45|528.49~REF|6R|10790870003Z3~AMT|B6|171.51~SVC|HC^G0151|700|167.89|0421~DTM|472|20251009~CAS|CO|45|532.11~REF|6R|10790870003Z4~AMT|B6|167.89~SVC|HC^G0152|700|171.51|0431~DTM|472|20251014~CAS|CO|45|528.49~REF|6R|10790870003Z5~AMT|B6|171.51~SVC|HC^G0151|700|167.89|0421~DTM|472|20251016~CAS|CO|45|532.11~REF|6R|10790870003Z6~AMT|B6|167.89~CLP|1150-251022123243|1|1400|258||HM|176774196|32|4~NM1|QC|1|GAO|DIANZHONG||||MI|19234287~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|19234287~REF|G1|1720110858~DTM|232|20251009~DTM|233|20251015~DTM|050|20251023~AMT|AU|1400~SVC|HC^G0151|700|139|0421~DTM|472|20251009~CAS|CO|45|561~REF|6R|10790153918Z1~AMT|B6|139~SVC|HC^G0299|700|119|0551~DTM|472|20251015~CAS|CO|45|581~REF|6R|10790153918Z2~AMT|B6|119~CLP|1150-251022164250|1|7000.01|2016||MA|176775318|32|9~NM1|QC|1|WALKER|CHARLES||||MI|23238139~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|23238139~REF|G1|1720033787~DTM|232|20250916~DTM|233|20251010~DTM|050|20251023~AMT|AU|7000.01~SVC|HC^1AA21|0|2016|0023~DTM|472|20250916~CAS|CO|45|-2057.14||253|41.14~REF|6R|10791301078Z1~AMT|B6|2057.14~LQ|HE|N669~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250916~CAS|CO|45|.01~REF|6R|10791301078Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250916~CAS|CO|45|700~REF|6R|10791301078Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20250918~CAS|CO|45|700~REF|6R|10791301078Z4~SVC|HC^G0299|700|0|0551|0~DTM|472|20250919~CAS|CO|45|700~REF|6R|10791301078Z5~SVC|HC^G0299|700|0|0551|0~DTM|472|20250922~CAS|CO|45|700~REF|6R|10791301078Z6~SVC|HC^G0151|700|0|0421|0~DTM|472|20250925~CAS|CO|45|700~REF|6R|10791301078Z7~SVC|HC^G0299|700|0|0551|0~DTM|472|20250930~CAS|CO|45|700~REF|6R|10791301078Z8~SVC|HC^G0151|700|0|0421|0~DTM|472|20251002~CAS|CO|45|700~REF|6R|10791301078Z9~SVC|HC^G0299|700|0|0551|0~DTM|472|20251009~CAS|CO|45|700~REF|6R|10791301078Z10~SVC|HC^G0151|700|0|0421|0~DTM|472|20251009~CAS|CO|45|700~REF|6R|10791301078Z11~SVC|HC^G0152|700|0|0431|0~DTM|472|20251010~CAS|CO|45|700~REF|6R|10791301078Z12~CLP|1150-251022145851|1|2100|478.43||HM|176774781|32|2~NM1|QC|1|SMITH|LAMONT||||MI|13290894~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|13290894~REF|G1|1720159032~DTM|232|20250918~DTM|233|20250926~DTM|050|20251023~AMT|AU|2100~SVC|HC^G0299|700|155.27|0551~DTM|472|20250918~CAS|CO|45|544.73~REF|6R|10790834563Z1~AMT|B6|155.27~SVC|HC^G0151|700|167.89|0421~DTM|472|20250924~CAS|CO|45|532.11~REF|6R|10790834563Z2~AMT|B6|167.89~SVC|HC^G0299|700|155.27|0551~DTM|472|20250926~CAS|CO|45|544.73~REF|6R|10790834563Z3~AMT|B6|155.27~CLP|1150-251022114910|1|4900|913||HM|176774191|32|2~NM1|QC|1|ARMSTRONG|DEJUANA||||MI|21327749~NM1|74|1|||M~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|21327749~REF|G1|1720209817~DTM|232|20251005~DTM|233|20251016~DTM|050|20251023~AMT|AU|4900~SVC|HC^G0299|700|119|0551~DTM|472|20251005~CAS|CO|45|581~REF|6R|10789954877Z1~AMT|B6|119~SVC|HC^G0151|700|139|0421~DTM|472|20251009~CAS|CO|45|561~REF|6R|10789954877Z2~AMT|B6|139~SVC|HC^G0299|700|119|0551~DTM|472|20251009~CAS|CO|45|581~REF|6R|10789954877Z3~AMT|B6|119~SVC|HC^G0299|700|119|0551~DTM|472|20251014~CAS|CO|45|581~REF|6R|10789954877Z4~AMT|B6|119~SVC|HC^G0151|700|139|0421~DTM|472|20251014~CAS|CO|45|561~REF|6R|10789954877Z5~AMT|B6|139~SVC|HC^G0152|700|139|0431~DTM|472|20251016~CAS|CO|45|561~REF|6R|10789954877Z6~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251016~CAS|CO|45|561~REF|6R|10789954877Z7~AMT|B6|139~CLP|1150-251022141916|1|2100|278|139|HM|176774227|32|2~NM1|QC|1|WILLIAMS|MARQUICE||||MI|33352043~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|33352043~REF|G1|1720140446~DTM|232|20250910~DTM|233|20251002~DTM|050|20251023~AMT|AU|2100~SVC|HC^G0151|700|139|0421~DTM|472|20250910~CAS|CO|45|561~REF|6R|10790653596Z1~AMT|B6|139~SVC|HC^G0157|700|139|0421~DTM|472|20250917~CAS|CO|45|561~REF|6R|10790653596Z2~AMT|B6|139~SVC|HC^G0157|700|0|0421|0~DTM|472|20251002~CAS|CO|45|561~CAS|PR|1|139~REF|6R|10790653596Z3~AMT|B6|139~CLP|1150-251022120242|1|1400|278||HM|176774193|32|4~NM1|QC|1|DE GUZMAN|EDUARDO||||MI|75143012~NM1|74|1|||L~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|75143012~REF|G1|1720153261~DTM|232|20251008~DTM|233|20251015~DTM|050|20251023~AMT|AU|1400~SVC|HC^G0157|700|139|0421~DTM|472|20251008~CAS|CO|45|561~REF|6R|10789992819Z1~AMT|B6|139~SVC|HC^G0157|700|139|0421~DTM|472|20251015~CAS|CO|45|561~REF|6R|10789992819Z2~AMT|B6|139~CLP|1150-251022143154|1|7000|1230||HM|176774229|32|3~NM1|QC|1|WYNDER|ROBERT||||MI|99144378~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|99144378~REF|G1|1720109616~DTM|232|20250929~DTM|233|20251015~DTM|050|20251023~AMT|AU|7000~SVC|HC^G0299|700|119|0551~DTM|472|20250929~CAS|CO|45|581~REF|6R|10790700791Z1~AMT|B6|119~SVC|HC^G0299|700|119|0551~DTM|472|20251001~CAS|CO|45|581~REF|6R|10790700791Z2~AMT|B6|119~SVC|HC^G0151|700|139|0421~DTM|472|20251002~CAS|CO|45|561~REF|6R|10790700791Z3~AMT|B6|139~SVC|HC^G0299|700|119|0551~DTM|472|20251003~CAS|CO|45|581~REF|6R|10790700791Z4~AMT|B6|119~SVC|HC^G0299|700|119|0551~DTM|472|20251005~CAS|CO|45|581~REF|6R|10790700791Z5~AMT|B6|119~SVC|HC^G0299|700|119|0551~DTM|472|20251007~CAS|CO|45|581~REF|6R|10790700791Z6~AMT|B6|119~SVC|HC^G0151|700|139|0421~DTM|472|20251009~CAS|CO|45|561~REF|6R|10790700791Z7~AMT|B6|139~SVC|HC^G0299|700|119|0551~DTM|472|20251010~CAS|CO|45|581~REF|6R|10790700791Z8~AMT|B6|119~SVC|HC^G0299|700|119|0551~DTM|472|20251013~CAS|CO|45|581~REF|6R|10790700791Z9~AMT|B6|119~SVC|HC^G0299|700|119|0551~DTM|472|20251015~CAS|CO|45|581~REF|6R|10790700791Z10~AMT|B6|119~CLP|1150-251022152354|1|6300.01|1865.36||MA|176775303|32|9~NM1|QC|1|THOMPSON|JAMES||||MI|64163433~NM1|74|1|||E~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|64163433~REF|G1|1720088193~DTM|232|20250822~DTM|233|20250910~DTM|050|20251023~AMT|AU|6300.01~SVC|HC^1KA11|0|1865.36|0023~DTM|472|20250822~CAS|CO|45|-1903.43||253|38.07~REF|6R|10790956158Z1~AMT|B6|1903.43~LQ|HE|N669~SVC|HC^Q5001|.01|0|0421|0~DTM|472|20250822~CAS|CO|45|.01~REF|6R|10790956158Z2~SVC|HC^G0151|700|0|0421|0~DTM|472|20250822~CAS|CO|45|700~REF|6R|10790956158Z3~SVC|HC^G0152|700|0|0431|0~DTM|472|20250825~CAS|CO|45|700~REF|6R|10790956158Z4~SVC|HC^G0151|700|0|0421|0~DTM|472|20250826~CAS|CO|45|700~REF|6R|10790956158Z5~SVC|HC^G0151|700|0|0421|0~DTM|472|20250827~CAS|CO|45|700~REF|6R|10790956158Z6~SVC|HC^G0151|700|0|0421|0~DTM|472|20250902~CAS|CO|45|700~REF|6R|10790956158Z7~SVC|HC^G0151|700|0|0421|0~DTM|472|20250904~CAS|CO|45|700~REF|6R|10790956158Z8~SVC|HC^G0152|700|0|0431|0~DTM|472|20250905~CAS|CO|45|700~REF|6R|10790956158Z9~SVC|HC^G0151|700|0|0421|0~DTM|472|20250908~CAS|CO|45|700~REF|6R|10790956158Z10~SVC|HC^G0151|700|0|0421|0~DTM|472|20250910~CAS|CO|45|700~REF|6R|10790956158Z11~CLP|1150-251022152453|1|1400.01|1149.79||MA|176775311|32|9~NM1|QC|1|THOMPSON|JAMES||||MI|64163433~NM1|74|1|||E~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|64163433~REF|G1|1720088194~DTM|232|20250922~DTM|233|20250930~DTM|050|20251023~AMT|AU|1400.01~SVC|HC^3KA11|0|1149.79|0023~DTM|472|20250922~CAS|CO|45|-1173.26||253|23.47~REF|6R|10790960767Z1~AMT|B6|1173.26~LQ|HE|N669~SVC|HC^Q5001|.01|0|0421|0~DTM|472|20250922~CAS|CO|45|.01~REF|6R|10790960767Z2~SVC|HC^G0151|700|0|0421|0~DTM|472|20250922~CAS|CO|45|700~REF|6R|10790960767Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20250930~CAS|CO|45|700~REF|6R|10790960767Z4~CLP|1150-251022123725|1|2100|0||HM|176774199|32|4~NM1|QC|1|GOMES|STEVENSON||||MI|15169267~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~MOA|||N702~REF|EA|15169267~REF|G1|1720070917~DTM|232|20250916~DTM|233|20250922~DTM|050|20251023~AMT|AU|2100~SVC|HC^G0151|700|0|0421|0~DTM|472|20250916~CAS|PI|18|700~REF|6R|10790189875Z1~LQ|HE|N702~SVC|HC^G0152|700|0|0431|0~DTM|472|20250922~CAS|PI|18|700~REF|6R|10790189875Z2~LQ|HE|N702~SVC|HC^G0151|700|0|0421|0~DTM|472|20250922~CAS|PI|18|700~REF|6R|10790189875Z3~LQ|HE|N702~CLP|1150-251022160252|1|6300.01|2467.07||MA|176775315|32|9~NM1|QC|1|VINCENT|MICHAEL||||MI|61186229~NM1|74|1|||A~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|61186229~REF|G1|1720130385~DTM|232|20250907~DTM|233|20251001~DTM|050|20251023~AMT|AU|6300.01~SVC|HC^1KC21|0|2467.07|0023~DTM|472|20250907~CAS|CO|45|-2517.42||253|50.35~REF|6R|10791140938Z1~AMT|B6|2517.42~LQ|HE|N669~SVC|HC^Q5001|.01|0|0551|0~DTM|472|20250907~CAS|CO|45|.01~REF|6R|10791140938Z2~SVC|HC^G0299|700|0|0551|0~DTM|472|20250907~CAS|CO|45|700~REF|6R|10791140938Z3~SVC|HC^G0151|700|0|0421|0~DTM|472|20250908~CAS|CO|45|700~REF|6R|10791140938Z4~SVC|HC^G0299|700|0|0551|0~DTM|472|20250911~CAS|CO|45|700~REF|6R|10791140938Z5~SVC|HC^G0157|700|0|0421|0~DTM|472|20250912~CAS|CO|45|700~REF|6R|10791140938Z6~SVC|HC^G0299|700|0|0551|0~DTM|472|20250916~CAS|CO|45|700~REF|6R|10791140938Z7~SVC|HC^G0157|700|0|0421|0~DTM|472|20250919~CAS|CO|45|700~REF|6R|10791140938Z8~SVC|HC^G0299|700|0|0551|0~DTM|472|20250923~CAS|CO|45|700~REF|6R|10791140938Z9~SVC|HC^G0157|700|0|0421|0~DTM|472|20250926~CAS|CO|45|700~REF|6R|10791140938Z10~SVC|HC^G0299|700|0|0551|0~DTM|472|20251001~CAS|CO|45|700~REF|6R|10791140938Z11~CLP|1150-251022143729|1|700|155.27||HM|176774774|32|4~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|20250925~DTM|233|20250925~DTM|050|20251023~AMT|AU|700~SVC|HC^G0299|700|155.27|0551~DTM|472|20250925~CAS|CO|45|544.73~REF|6R|10790735128Z1~AMT|B6|155.27~CLP|1150-251022131423|1|700|119||HM|176774213|32|2~NM1|QC|1|RODAS|DELIA||||MI|24203698~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|24203698~REF|G1|1720067743~DTM|232|20250818~DTM|233|20250818~DTM|050|20251023~AMT|AU|700~SVC|HC^G0299|700|119|0551~DTM|472|20250818~CAS|CO|45|581~REF|6R|10790380955Z1~AMT|B6|119~CLP|1150-251022131455|1|700|119||HM|176774216|32|4~NM1|QC|1|RODAS|DELIA||||MI|24203698~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|24203698~REF|G1|1720067743~DTM|232|20251001~DTM|233|20251001~DTM|050|20251023~AMT|AU|700~SVC|HC^G0299|700|119|0551~DTM|472|20251001~CAS|CO|45|581~REF|6R|10790381008Z1~AMT|B6|119~CLP|1150-251022121650|1|6300|1171||HM|176774194|32|3~NM1|QC|1|FUENTES|ANGEL||||MI|37205608~NM1|74|1|||R~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|37205608~REF|G1|1719963111~DTM|232|20250926~DTM|233|20251016~DTM|050|20251023~AMT|AU|6300~SVC|HC^G0299|700|119|0551~DTM|472|20250926~CAS|CO|45|581~REF|6R|10790133742Z1~AMT|B6|119~SVC|HC^G0151|700|139|0421~DTM|472|20251001~CAS|CO|45|561~REF|6R|10790133742Z2~AMT|B6|139~SVC|HC^G0299|700|119|0551~DTM|472|20251002~CAS|CO|45|581~REF|6R|10790133742Z3~AMT|B6|119~SVC|HC^G0152|700|139|0431~DTM|472|20251008~CAS|CO|45|561~REF|6R|10790133742Z4~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251008~CAS|CO|45|561~REF|6R|10790133742Z5~AMT|B6|139~SVC|HC^G0299|700|119|0551~DTM|472|20251009~CAS|CO|45|581~REF|6R|10790133742Z6~AMT|B6|119~SVC|HC^G0151|700|139|0421~DTM|472|20251015~CAS|CO|45|561~REF|6R|10790133742Z7~AMT|B6|139~SVC|HC^G0152|700|139|0431~DTM|472|20251015~CAS|CO|45|561~REF|6R|10790133742Z8~AMT|B6|139~SVC|HC^G0299|700|119|0551~DTM|472|20251016~CAS|CO|45|581~REF|6R|10790133742Z9~AMT|B6|119~CLP|1150-251022154353|1|4900.01|1245.56||MA|176775316|32|9~NM1|QC|1|TYLER|JAYNE||||MI|54215010~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|54215010~REF|G1|1720000403~DTM|232|20250922~DTM|233|20251015~DTM|050|20251023~AMT|AU|4900.01~SVC|HC^3EA11|0|1245.56|0023~DTM|472|20250922~CAS|CO|45|-1270.98||253|25.42~REF|6R|10791062742Z1~AMT|B6|1270.98~LQ|HE|N669~SVC|HC^Q5001|.01|0|0421|0~DTM|472|20250922~CAS|CO|45|.01~REF|6R|10791062742Z2~SVC|HC^G0151|700|0|0421|0~DTM|472|20250922~CAS|CO|45|700~REF|6R|10791062742Z3~SVC|HC^G0152|700|0|0431|0~DTM|472|20250924~CAS|CO|45|700~REF|6R|10791062742Z4~SVC|HC^G0151|700|0|0421|0~DTM|472|20250929~CAS|CO|45|700~REF|6R|10791062742Z5~SVC|HC^G0152|700|0|0431|0~DTM|472|20251001~CAS|CO|45|700~REF|6R|10791062742Z6~SVC|HC^G0151|700|0|0421|0~DTM|472|20251007~CAS|CO|45|700~REF|6R|10791062742Z7~SVC|HC^G0152|700|0|0431|0~DTM|472|20251008~CAS|CO|45|700~REF|6R|10791062742Z8~SVC|HC^G0152|700|0|0431|0~DTM|472|20251015~CAS|CO|45|700~REF|6R|10791062742Z9~CLP|1150-251022125635|1|4200|714||HM|176774203|32|3~NM1|QC|1|JOSEPH|ERICA||||MI|87222945~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|87222945~REF|G1|1719800049~DTM|232|20251006~DTM|233|20251017~DTM|050|20251023~AMT|AU|4200~SVC|HC^G0299|700|119|0551~DTM|472|20251006~CAS|CO|45|581~REF|6R|10790287990Z1~AMT|B6|119~SVC|HC^G0299|700|119|0551~DTM|472|20251008~CAS|CO|45|581~REF|6R|10790287990Z2~AMT|B6|119~SVC|HC^G0299|700|119|0551~DTM|472|20251010~CAS|CO|45|581~REF|6R|10790287990Z3~AMT|B6|119~SVC|HC^G0299|700|119|0551~DTM|472|20251013~CAS|CO|45|581~REF|6R|10790287990Z4~AMT|B6|119~SVC|HC^G0299|700|119|0551~DTM|472|20251015~CAS|CO|45|581~REF|6R|10790287990Z5~AMT|B6|119~SVC|HC^G0299|700|119|0551~DTM|472|20251017~CAS|CO|45|581~REF|6R|10790287990Z6~AMT|B6|119~CLP|1150-251022135623|1|4200|834||HM|176774221|32|2~NM1|QC|1|WALKER|SUSAN||||MI|77223479~NM1|74|1|||S~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|77223479~REF|G1|1720182202~DTM|232|20250926~DTM|233|20251015~DTM|050|20251023~AMT|AU|4200~SVC|HC^G0151|700|139|0421~DTM|472|20250926~CAS|CO|45|561~REF|6R|10790576438Z1~AMT|B6|139~SVC|HC^G0157|700|139|0421~DTM|472|20251001~CAS|CO|45|561~REF|6R|10790576438Z2~AMT|B6|139~SVC|HC^G0157|700|139|0421~DTM|472|20251002~CAS|CO|45|561~REF|6R|10790576438Z3~AMT|B6|139~SVC|HC^G0157|700|139|0421~DTM|472|20251009~CAS|CO|45|561~REF|6R|10790576438Z4~AMT|B6|139~SVC|HC^G0152|700|139|0431~DTM|472|20251010~CAS|CO|45|561~REF|6R|10790576438Z5~AMT|B6|139~SVC|HC^G0157|700|139|0421~DTM|472|20251015~CAS|CO|45|561~REF|6R|10790576438Z6~AMT|B6|139~SE|1013|0001~GE|1|3452~IEA|1|000003452~