ISA|00|          |00|          |ZZ|ZIRMED         |ZZ|923001C9807506 |251118|0839|}|00501|000003460|0|P|^~GS|HP|ZIRMED|923001C9807506|20251118|0839|3460|X|005010X221A1~ST|835|0001~BPR|I|9170|C|ACH|CCP|01|031100209|DA|38876542|1520954463||01|055002338|DA|93128821|20251118~TRN|1|000001850788637|1520954463~DTM|405|20251118~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|1150-251111122031|1|5600|1072||HM|178065113|32|1~NM1|QC|1|DIXON|PATRICIA||||MI|181124597~NM1|74|1|||P~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|181124597~REF|G1|1720174334~DTM|232|20251014~DTM|233|20251027~DTM|050|20251112~AMT|AU|5600~SVC|HC^G0299|700|119|0551~DTM|472|20251014~CAS|CO|45|581~REF|6R|10904830569Z1~AMT|B6|119~SVC|HC^G0151|700|139|0421~DTM|472|20251014~CAS|CO|45|561~REF|6R|10904830569Z2~AMT|B6|139~SVC|HC^G0157|700|139|0421~DTM|472|20251016~CAS|CO|45|561~REF|6R|10904830569Z3~AMT|B6|139~SVC|HC^G0299|700|119|0551~DTM|472|20251020~CAS|CO|45|581~REF|6R|10904830569Z4~AMT|B6|119~SVC|HC^G0157|700|139|0421~DTM|472|20251021~CAS|CO|45|561~REF|6R|10904830569Z5~AMT|B6|139~SVC|HC^G0157|700|139|0421~DTM|472|20251022~CAS|CO|45|561~REF|6R|10904830569Z6~AMT|B6|139~SVC|HC^G0157|700|139|0421~DTM|472|20251023~CAS|CO|45|561~REF|6R|10904830569Z7~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251027~CAS|CO|45|561~REF|6R|10904830569Z8~AMT|B6|139~CLP|1150-251111153332|1|2800|516||HM|178065126|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|1720182416~DTM|232|20251018~DTM|233|20251024~DTM|050|20251112~AMT|AU|2800~SVC|HC^G0299|700|119|0551~DTM|472|20251018~CAS|CO|45|581~REF|6R|10905633215Z1~AMT|B6|119~SVC|HC^G0299|700|119|0551~DTM|472|20251020~CAS|CO|45|581~REF|6R|10905633215Z2~AMT|B6|119~SVC|HC^G0152|700|139|0431~DTM|472|20251022~CAS|CO|45|561~REF|6R|10905633215Z3~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251024~CAS|CO|45|561~REF|6R|10905633215Z4~AMT|B6|139~CLP|1150-251111155308|1|5600|1072||HM|178065138|32|1~NM1|QC|1|SHIELDS-DAVIS|TOWANDA||||MI|01234109~NM1|74|1|||M~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|01234109~REF|G1|1720234023~DTM|232|20251023~DTM|233|20251105~DTM|050|20251112~AMT|AU|5600~SVC|HC^G0299|700|119|0551~DTM|472|20251023~CAS|CO|45|581~REF|6R|10905726245Z1~AMT|B6|119~SVC|HC^G0151|700|139|0421~DTM|472|20251023~CAS|CO|45|561~REF|6R|10905726245Z2~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251025~CAS|CO|45|561~REF|6R|10905726245Z3~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251027~CAS|CO|45|561~REF|6R|10905726245Z4~AMT|B6|139~SVC|HC^G0299|700|119|0551~DTM|472|20251028~CAS|CO|45|581~REF|6R|10905726245Z5~AMT|B6|119~SVC|HC^G0151|700|139|0421~DTM|472|20251030~CAS|CO|45|561~REF|6R|10905726245Z6~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251103~CAS|CO|45|561~REF|6R|10905726245Z7~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251105~CAS|CO|45|561~REF|6R|10905726245Z8~AMT|B6|139~CLP|1150-251111154655|1|5600|1072||HM|178065134|32|1~NM1|QC|1|SHIELDS|SHELLY||||MI|071033151~NM1|74|1|||A~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|071033151~REF|G1|1720241179~DTM|232|20251022~DTM|233|20251103~DTM|050|20251112~AMT|AU|5600~SVC|HC^G0299|700|119|0551~DTM|472|20251022~CAS|CO|45|581~REF|6R|10905697443Z1~AMT|B6|119~SVC|HC^G0151|700|139|0421~DTM|472|20251022~CAS|CO|45|561~REF|6R|10905697443Z2~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251024~CAS|CO|45|561~REF|6R|10905697443Z3~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251027~CAS|CO|45|561~REF|6R|10905697443Z4~AMT|B6|139~SVC|HC^G0299|700|119|0551~DTM|472|20251028~CAS|CO|45|581~REF|6R|10905697443Z5~AMT|B6|119~SVC|HC^G0151|700|139|0421~DTM|472|20251029~CAS|CO|45|561~REF|6R|10905697443Z6~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251031~CAS|CO|45|561~REF|6R|10905697443Z7~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251103~CAS|CO|45|561~REF|6R|10905697443Z8~AMT|B6|139~CLP|1150-251111144058|1|5600|1072||HM|178065117|32|1~NM1|QC|1|HEVNER|DEBORAH||||MI|52579171~NM1|74|1|||CRISTINE|||C|15257917~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|15257917~REF|G1|1720204677~DTM|232|20251023~DTM|233|20251105~DTM|050|20251112~AMT|AU|5600~SVC|HC^G0299|700|119|0551~DTM|472|20251023~CAS|CO|45|581~REF|6R|10905424383Z1~AMT|B6|119~SVC|HC^G0151|700|139|0421~DTM|472|20251023~CAS|CO|45|561~REF|6R|10905424383Z2~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251025~CAS|CO|45|561~REF|6R|10905424383Z3~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251027~CAS|CO|45|561~REF|6R|10905424383Z4~AMT|B6|139~SVC|HC^G0299|700|119|0551~DTM|472|20251028~CAS|CO|45|581~REF|6R|10905424383Z5~AMT|B6|119~SVC|HC^G0151|700|139|0421~DTM|472|20251030~CAS|CO|45|561~REF|6R|10905424383Z6~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251103~CAS|CO|45|561~REF|6R|10905424383Z7~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251105~CAS|CO|45|561~REF|6R|10905424383Z8~AMT|B6|139~CLP|1150-251111115645|1|4200|774||HM|178065105|32|2~NM1|QC|1|BOND|QUYENTEN||||MI|93271461~NM1|74|1|||DAVID~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|93271461~REF|G1|1720257059~DTM|232|20251023~DTM|233|20251030~DTM|050|20251112~AMT|AU|4200~SVC|HC^G0299|700|119|0551~DTM|472|20251023~CAS|CO|45|581~REF|6R|10904677513Z1~AMT|B6|119~SVC|HC^G0151|700|139|0421~DTM|472|20251023~CAS|CO|45|561~REF|6R|10904677513Z2~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251027~CAS|CO|45|561~REF|6R|10904677513Z3~AMT|B6|139~SVC|HC^G0299|700|119|0551~DTM|472|20251027~CAS|CO|45|581~REF|6R|10904677513Z4~AMT|B6|119~SVC|HC^G0151|700|139|0421~DTM|472|20251030~CAS|CO|45|561~REF|6R|10904677513Z5~AMT|B6|139~SVC|HC^G0299|700|119|0551~DTM|472|20251030~CAS|CO|45|581~REF|6R|10904677513Z6~AMT|B6|119~CLP|1150-251111145240|1|5600|1072||HM|178065120|32|1~NM1|QC|1|HUGHES|MARCUS||||MI|91282023~NM1|74|1|||L~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|91282023~REF|G1|1719887893~DTM|232|20251018~DTM|233|20251103~DTM|050|20251112~AMT|AU|5600~SVC|HC^G0299|700|119|0551~DTM|472|20251018~CAS|CO|45|581~REF|6R|10905459947Z1~AMT|B6|119~SVC|HC^G0151|700|139|0421~DTM|472|20251020~CAS|CO|45|561~REF|6R|10905459947Z2~AMT|B6|139~SVC|HC^G0299|700|119|0551~DTM|472|20251023~CAS|CO|45|581~REF|6R|10905459947Z3~AMT|B6|119~SVC|HC^G0157|700|139|0421~DTM|472|20251023~CAS|CO|45|561~REF|6R|10905459947Z4~AMT|B6|139~SVC|HC^G0157|700|139|0421~DTM|472|20251027~CAS|CO|45|561~REF|6R|10905459947Z5~AMT|B6|139~SVC|HC^G0157|700|139|0421~DTM|472|20251029~CAS|CO|45|561~REF|6R|10905459947Z6~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251031~CAS|CO|45|561~REF|6R|10905459947Z7~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251103~CAS|CO|45|561~REF|6R|10905459947Z8~AMT|B6|139~CLP|1150-251111121245|1|5600|1072||HM|178065110|32|1~NM1|QC|1|CARROLL|KIMBERLY||||MI|57347988~NM1|74|1|||D~NM1|82|2|HOMECENTRIS HOME HEALTH II LLC|||||XX|1487113239~REF|EA|57347988~REF|G1|1720174371~DTM|232|20251010~DTM|233|20251022~DTM|050|20251112~AMT|AU|5600~SVC|HC^G0299|700|119|0551~DTM|472|20251010~CAS|CO|45|581~REF|6R|10904784520Z1~AMT|B6|119~SVC|HC^G0151|700|139|0421~DTM|472|20251010~CAS|CO|45|561~REF|6R|10904784520Z2~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251013~CAS|CO|45|561~REF|6R|10904784520Z3~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251015~CAS|CO|45|561~REF|6R|10904784520Z4~AMT|B6|139~SVC|HC^G0299|700|119|0551~DTM|472|20251016~CAS|CO|45|581~REF|6R|10904784520Z5~AMT|B6|119~SVC|HC^G0151|700|139|0421~DTM|472|20251017~CAS|CO|45|561~REF|6R|10904784520Z6~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251020~CAS|CO|45|561~REF|6R|10904784520Z7~AMT|B6|139~SVC|HC^G0151|700|139|0421~DTM|472|20251022~CAS|CO|45|561~REF|6R|10904784520Z8~AMT|B6|139~CLP|1150-251111160552|1|4200|734||HM|178065141|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|20251017~DTM|233|20251027~DTM|050|20251112~AMT|AU|4200~SVC|HC^G0299|700|119|0551~DTM|472|20251017~CAS|CO|45|581~REF|6R|10905791897Z1~AMT|B6|119~SVC|HC^G0299|700|119|0551~DTM|472|20251020~CAS|CO|45|581~REF|6R|10905791897Z2~AMT|B6|119~SVC|HC^G0299|700|119|0551~DTM|472|20251022~CAS|CO|45|581~REF|6R|10905791897Z3~AMT|B6|119~SVC|HC^G0151|700|139|0421~DTM|472|20251023~CAS|CO|45|561~REF|6R|10905791897Z4~AMT|B6|139~SVC|HC^G0299|700|119|0551~DTM|472|20251024~CAS|CO|45|581~REF|6R|10905791897Z5~AMT|B6|119~SVC|HC^G0299|700|119|0551~DTM|472|20251027~CAS|CO|45|581~REF|6R|10905791897Z6~AMT|B6|119~CLP|1150-251111150247|1|4200|714||HM|178065124|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|20251020~DTM|233|20251103~DTM|050|20251112~AMT|AU|4200~SVC|HC^G0299|700|119|0551~DTM|472|20251020~CAS|CO|45|581~REF|6R|10905497865Z1~AMT|B6|119~SVC|HC^G0299|700|119|0551~DTM|472|20251024~CAS|CO|45|581~REF|6R|10905497865Z2~AMT|B6|119~SVC|HC^G0299|700|119|0551~DTM|472|20251027~CAS|CO|45|581~REF|6R|10905497865Z3~AMT|B6|119~SVC|HC^G0299|700|119|0551~DTM|472|20251029~CAS|CO|45|581~REF|6R|10905497865Z4~AMT|B6|119~SVC|HC^G0299|700|119|0551~DTM|472|20251101~CAS|CO|45|581~REF|6R|10905497865Z5~AMT|B6|119~SVC|HC^G0299|700|119|0551~DTM|472|20251103~CAS|CO|45|581~REF|6R|10905497865Z6~AMT|B6|119~SE|463|0001~GE|1|3460~IEA|1|000003460~