| control_number,transaction_set,claim_id,document |
| 904215028,837P,CLM447464,"ISA*00* *00* *ZZ*SUBMITTER *ZZ*RECEIVER *20260628*1200*^*00501*904215028*0*T*:~ |
| GS*HC*SUBMITTER*RECEIVER*20260628*1200*1*X*005010X222A1~ |
| ST*837*0001*005010X222A1~ |
| BHT*0019*00*CLM447464*20260628*1200*CH~ |
| NM1*41*2*SYNTHETIC SUBMITTER*****46*699457619~ |
| NM1*40*2*SYNTHETIC RECEIVER*****46*875989804~ |
| CLM*CLM447464*150.00***11:B:1*Y*A*Y*Y~ |
| SE*7*0001~ |
| GE*1*904215028~ |
| IEA*1*904215028~" |
| 499009403,837P,CLM393148,"ISA*00* *00* *ZZ*SUBMITTER *ZZ*RECEIVER *20260607*1200*^*00501*499009403*0*T*:~ |
| GS*HC*SUBMITTER*RECEIVER*20260607*1200*1*X*005010X222A1~ |
| ST*837*0001*005010X222A1~ |
| BHT*0019*00*CLM393148*20260607*1200*CH~ |
| NM1*41*2*SYNTHETIC SUBMITTER*****46*468154607~ |
| NM1*40*2*SYNTHETIC RECEIVER*****46*087534968~ |
| CLM*CLM393148*150.00***11:B:1*Y*A*Y*Y~ |
| SE*7*0001~ |
| GE*1*499009403~ |
| IEA*1*499009403~" |
| 135363379,837P,CLM964910,"ISA*00* *00* *ZZ*SUBMITTER *ZZ*RECEIVER *20260518*1200*^*00501*135363379*0*T*:~ |
| GS*HC*SUBMITTER*RECEIVER*20260518*1200*1*X*005010X222A1~ |
| ST*837*0001*005010X222A1~ |
| BHT*0019*00*CLM964910*20260518*1200*CH~ |
| NM1*41*2*SYNTHETIC SUBMITTER*****46*068353092~ |
| NM1*40*2*SYNTHETIC RECEIVER*****46*809557263~ |
| CLM*CLM964910*150.00***11:B:1*Y*A*Y*Y~ |
| SE*7*0001~ |
| GE*1*135363379~ |
| IEA*1*135363379~" |
| 047196218,837P,CLM684256,"ISA*00* *00* *ZZ*SUBMITTER *ZZ*RECEIVER *20261118*1200*^*00501*047196218*0*T*:~ |
| GS*HC*SUBMITTER*RECEIVER*20261118*1200*1*X*005010X222A1~ |
| ST*837*0001*005010X222A1~ |
| BHT*0019*00*CLM684256*20261118*1200*CH~ |
| NM1*41*2*SYNTHETIC SUBMITTER*****46*503091336~ |
| NM1*40*2*SYNTHETIC RECEIVER*****46*415702215~ |
| CLM*CLM684256*150.00***11:B:1*Y*A*Y*Y~ |
| SE*7*0001~ |
| GE*1*047196218~ |
| IEA*1*047196218~" |
| 455422120,837P,CLM873092,"ISA*00* *00* *ZZ*SUBMITTER *ZZ*RECEIVER *20260508*1200*^*00501*455422120*0*T*:~ |
| GS*HC*SUBMITTER*RECEIVER*20260508*1200*1*X*005010X222A1~ |
| ST*837*0001*005010X222A1~ |
| BHT*0019*00*CLM873092*20260508*1200*CH~ |
| NM1*41*2*SYNTHETIC SUBMITTER*****46*372826639~ |
| NM1*40*2*SYNTHETIC RECEIVER*****46*782281174~ |
| CLM*CLM873092*150.00***11:B:1*Y*A*Y*Y~ |
| SE*7*0001~ |
| GE*1*455422120~ |
| IEA*1*455422120~" |
| 589406485,837P,CLM652286,"ISA*00* *00* *ZZ*SUBMITTER *ZZ*RECEIVER *20260512*1200*^*00501*589406485*0*T*:~ |
| GS*HC*SUBMITTER*RECEIVER*20260512*1200*1*X*005010X222A1~ |
| ST*837*0001*005010X222A1~ |
| BHT*0019*00*CLM652286*20260512*1200*CH~ |
| NM1*41*2*SYNTHETIC SUBMITTER*****46*471042865~ |
| NM1*40*2*SYNTHETIC RECEIVER*****46*756781178~ |
| CLM*CLM652286*150.00***11:B:1*Y*A*Y*Y~ |
| SE*7*0001~ |
| GE*1*589406485~ |
| IEA*1*589406485~" |
| 218195998,837P,CLM988652,"ISA*00* *00* *ZZ*SUBMITTER *ZZ*RECEIVER *20260111*1200*^*00501*218195998*0*T*:~ |
| GS*HC*SUBMITTER*RECEIVER*20260111*1200*1*X*005010X222A1~ |
| ST*837*0001*005010X222A1~ |
| BHT*0019*00*CLM988652*20260111*1200*CH~ |
| NM1*41*2*SYNTHETIC SUBMITTER*****46*481779282~ |
| NM1*40*2*SYNTHETIC RECEIVER*****46*560991017~ |
| CLM*CLM988652*150.00***11:B:1*Y*A*Y*Y~ |
| SE*7*0001~ |
| GE*1*218195998~ |
| IEA*1*218195998~" |
| 910879731,837P,CLM036132,"ISA*00* *00* *ZZ*SUBMITTER *ZZ*RECEIVER *20260118*1200*^*00501*910879731*0*T*:~ |
| GS*HC*SUBMITTER*RECEIVER*20260118*1200*1*X*005010X222A1~ |
| ST*837*0001*005010X222A1~ |
| BHT*0019*00*CLM036132*20260118*1200*CH~ |
| NM1*41*2*SYNTHETIC SUBMITTER*****46*140146298~ |
| NM1*40*2*SYNTHETIC RECEIVER*****46*566781445~ |
| CLM*CLM036132*150.00***11:B:1*Y*A*Y*Y~ |
| SE*7*0001~ |
| GE*1*910879731~ |
| IEA*1*910879731~" |
| 943786922,837P,CLM681962,"ISA*00* *00* *ZZ*SUBMITTER *ZZ*RECEIVER *20260101*1200*^*00501*943786922*0*T*:~ |
| GS*HC*SUBMITTER*RECEIVER*20260101*1200*1*X*005010X222A1~ |
| ST*837*0001*005010X222A1~ |
| BHT*0019*00*CLM681962*20260101*1200*CH~ |
| NM1*41*2*SYNTHETIC SUBMITTER*****46*896746068~ |
| NM1*40*2*SYNTHETIC RECEIVER*****46*742738879~ |
| CLM*CLM681962*150.00***11:B:1*Y*A*Y*Y~ |
| SE*7*0001~ |
| GE*1*943786922~ |
| IEA*1*943786922~" |
| 934347052,837P,CLM096431,"ISA*00* *00* *ZZ*SUBMITTER *ZZ*RECEIVER *20260201*1200*^*00501*934347052*0*T*:~ |
| GS*HC*SUBMITTER*RECEIVER*20260201*1200*1*X*005010X222A1~ |
| ST*837*0001*005010X222A1~ |
| BHT*0019*00*CLM096431*20260201*1200*CH~ |
| NM1*41*2*SYNTHETIC SUBMITTER*****46*274258153~ |
| NM1*40*2*SYNTHETIC RECEIVER*****46*019887206~ |
| CLM*CLM096431*150.00***11:B:1*Y*A*Y*Y~ |
| SE*7*0001~ |
| GE*1*934347052~ |
| IEA*1*934347052~" |
| 311811170,837P,CLM943866,"ISA*00* *00* *ZZ*SUBMITTER *ZZ*RECEIVER *20261125*1200*^*00501*311811170*0*T*:~ |
| GS*HC*SUBMITTER*RECEIVER*20261125*1200*1*X*005010X222A1~ |
| ST*837*0001*005010X222A1~ |
| BHT*0019*00*CLM943866*20261125*1200*CH~ |
| NM1*41*2*SYNTHETIC SUBMITTER*****46*696508303~ |
| NM1*40*2*SYNTHETIC RECEIVER*****46*770208031~ |
| CLM*CLM943866*150.00***11:B:1*Y*A*Y*Y~ |
| SE*7*0001~ |
| GE*1*311811170~ |
| IEA*1*311811170~" |
| 287711176,837P,CLM062153,"ISA*00* *00* *ZZ*SUBMITTER *ZZ*RECEIVER *20260206*1200*^*00501*287711176*0*T*:~ |
| GS*HC*SUBMITTER*RECEIVER*20260206*1200*1*X*005010X222A1~ |
| ST*837*0001*005010X222A1~ |
| BHT*0019*00*CLM062153*20260206*1200*CH~ |
| NM1*41*2*SYNTHETIC SUBMITTER*****46*199265643~ |
| NM1*40*2*SYNTHETIC RECEIVER*****46*047191182~ |
| CLM*CLM062153*150.00***11:B:1*Y*A*Y*Y~ |
| SE*7*0001~ |
| GE*1*287711176~ |
| IEA*1*287711176~" |
| 247767370,837P,CLM070436,"ISA*00* *00* *ZZ*SUBMITTER *ZZ*RECEIVER *20261102*1200*^*00501*247767370*0*T*:~ |
| GS*HC*SUBMITTER*RECEIVER*20261102*1200*1*X*005010X222A1~ |
| ST*837*0001*005010X222A1~ |
| BHT*0019*00*CLM070436*20261102*1200*CH~ |
| NM1*41*2*SYNTHETIC SUBMITTER*****46*045560746~ |
| NM1*40*2*SYNTHETIC RECEIVER*****46*592308967~ |
| CLM*CLM070436*150.00***11:B:1*Y*A*Y*Y~ |
| SE*7*0001~ |
| GE*1*247767370~ |
| IEA*1*247767370~" |
| 008347395,837P,CLM397444,"ISA*00* *00* *ZZ*SUBMITTER *ZZ*RECEIVER *20260905*1200*^*00501*008347395*0*T*:~ |
| GS*HC*SUBMITTER*RECEIVER*20260905*1200*1*X*005010X222A1~ |
| ST*837*0001*005010X222A1~ |
| BHT*0019*00*CLM397444*20260905*1200*CH~ |
| NM1*41*2*SYNTHETIC SUBMITTER*****46*082333276~ |
| NM1*40*2*SYNTHETIC RECEIVER*****46*361985418~ |
| CLM*CLM397444*150.00***11:B:1*Y*A*Y*Y~ |
| SE*7*0001~ |
| GE*1*008347395~ |
| IEA*1*008347395~" |
| 306524925,837P,CLM338131,"ISA*00* *00* *ZZ*SUBMITTER *ZZ*RECEIVER *20260302*1200*^*00501*306524925*0*T*:~ |
| GS*HC*SUBMITTER*RECEIVER*20260302*1200*1*X*005010X222A1~ |
| ST*837*0001*005010X222A1~ |
| BHT*0019*00*CLM338131*20260302*1200*CH~ |
| NM1*41*2*SYNTHETIC SUBMITTER*****46*800862655~ |
| NM1*40*2*SYNTHETIC RECEIVER*****46*099389431~ |
| CLM*CLM338131*150.00***11:B:1*Y*A*Y*Y~ |
| SE*7*0001~ |
| GE*1*306524925~ |
| IEA*1*306524925~" |
| 961311698,837P,CLM119141,"ISA*00* *00* *ZZ*SUBMITTER *ZZ*RECEIVER *20260912*1200*^*00501*961311698*0*T*:~ |
| GS*HC*SUBMITTER*RECEIVER*20260912*1200*1*X*005010X222A1~ |
| ST*837*0001*005010X222A1~ |
| BHT*0019*00*CLM119141*20260912*1200*CH~ |
| NM1*41*2*SYNTHETIC SUBMITTER*****46*003516016~ |
| NM1*40*2*SYNTHETIC RECEIVER*****46*913603170~ |
| CLM*CLM119141*150.00***11:B:1*Y*A*Y*Y~ |
| SE*7*0001~ |
| GE*1*961311698~ |
| IEA*1*961311698~" |
| 030874567,837P,CLM608240,"ISA*00* *00* *ZZ*SUBMITTER *ZZ*RECEIVER *20260112*1200*^*00501*030874567*0*T*:~ |
| GS*HC*SUBMITTER*RECEIVER*20260112*1200*1*X*005010X222A1~ |
| ST*837*0001*005010X222A1~ |
| BHT*0019*00*CLM608240*20260112*1200*CH~ |
| NM1*41*2*SYNTHETIC SUBMITTER*****46*916759875~ |
| NM1*40*2*SYNTHETIC RECEIVER*****46*973227192~ |
| CLM*CLM608240*150.00***11:B:1*Y*A*Y*Y~ |
| SE*7*0001~ |
| GE*1*030874567~ |
| IEA*1*030874567~" |
| 273776087,837P,CLM112873,"ISA*00* *00* *ZZ*SUBMITTER *ZZ*RECEIVER *20260812*1200*^*00501*273776087*0*T*:~ |
| GS*HC*SUBMITTER*RECEIVER*20260812*1200*1*X*005010X222A1~ |
| ST*837*0001*005010X222A1~ |
| BHT*0019*00*CLM112873*20260812*1200*CH~ |
| NM1*41*2*SYNTHETIC SUBMITTER*****46*998459579~ |
| NM1*40*2*SYNTHETIC RECEIVER*****46*578536493~ |
| CLM*CLM112873*150.00***11:B:1*Y*A*Y*Y~ |
| SE*7*0001~ |
| GE*1*273776087~ |
| IEA*1*273776087~" |
| 897740548,837P,CLM365648,"ISA*00* *00* *ZZ*SUBMITTER *ZZ*RECEIVER *20261218*1200*^*00501*897740548*0*T*:~ |
| GS*HC*SUBMITTER*RECEIVER*20261218*1200*1*X*005010X222A1~ |
| ST*837*0001*005010X222A1~ |
| BHT*0019*00*CLM365648*20261218*1200*CH~ |
| NM1*41*2*SYNTHETIC SUBMITTER*****46*559244181~ |
| NM1*40*2*SYNTHETIC RECEIVER*****46*935513405~ |
| CLM*CLM365648*150.00***11:B:1*Y*A*Y*Y~ |
| SE*7*0001~ |
| GE*1*897740548~ |
| IEA*1*897740548~" |
| 842686321,837P,CLM006151,"ISA*00* *00* *ZZ*SUBMITTER *ZZ*RECEIVER *20261013*1200*^*00501*842686321*0*T*:~ |
| GS*HC*SUBMITTER*RECEIVER*20261013*1200*1*X*005010X222A1~ |
| ST*837*0001*005010X222A1~ |
| BHT*0019*00*CLM006151*20261013*1200*CH~ |
| NM1*41*2*SYNTHETIC SUBMITTER*****46*847115460~ |
| NM1*40*2*SYNTHETIC RECEIVER*****46*394927608~ |
| CLM*CLM006151*150.00***11:B:1*Y*A*Y*Y~ |
| SE*7*0001~ |
| GE*1*842686321~ |
| IEA*1*842686321~" |
| 979334953,837P,CLM182773,"ISA*00* *00* *ZZ*SUBMITTER *ZZ*RECEIVER *20260121*1200*^*00501*979334953*0*T*:~ |
| GS*HC*SUBMITTER*RECEIVER*20260121*1200*1*X*005010X222A1~ |
| ST*837*0001*005010X222A1~ |
| BHT*0019*00*CLM182773*20260121*1200*CH~ |
| NM1*41*2*SYNTHETIC SUBMITTER*****46*852099254~ |
| NM1*40*2*SYNTHETIC RECEIVER*****46*394268317~ |
| CLM*CLM182773*150.00***11:B:1*Y*A*Y*Y~ |
| SE*7*0001~ |
| GE*1*979334953~ |
| IEA*1*979334953~" |
| 596674428,837P,CLM314674,"ISA*00* *00* *ZZ*SUBMITTER *ZZ*RECEIVER *20260917*1200*^*00501*596674428*0*T*:~ |
| GS*HC*SUBMITTER*RECEIVER*20260917*1200*1*X*005010X222A1~ |
| ST*837*0001*005010X222A1~ |
| BHT*0019*00*CLM314674*20260917*1200*CH~ |
| NM1*41*2*SYNTHETIC SUBMITTER*****46*062299087~ |
| NM1*40*2*SYNTHETIC RECEIVER*****46*136301560~ |
| CLM*CLM314674*150.00***11:B:1*Y*A*Y*Y~ |
| SE*7*0001~ |
| GE*1*596674428~ |
| IEA*1*596674428~" |
| 827981771,837P,CLM949909,"ISA*00* *00* *ZZ*SUBMITTER *ZZ*RECEIVER *20260823*1200*^*00501*827981771*0*T*:~ |
| GS*HC*SUBMITTER*RECEIVER*20260823*1200*1*X*005010X222A1~ |
| ST*837*0001*005010X222A1~ |
| BHT*0019*00*CLM949909*20260823*1200*CH~ |
| NM1*41*2*SYNTHETIC SUBMITTER*****46*753797367~ |
| NM1*40*2*SYNTHETIC RECEIVER*****46*378715926~ |
| CLM*CLM949909*150.00***11:B:1*Y*A*Y*Y~ |
| SE*7*0001~ |
| GE*1*827981771~ |
| IEA*1*827981771~" |
| 859764129,837P,CLM603729,"ISA*00* *00* *ZZ*SUBMITTER *ZZ*RECEIVER *20260723*1200*^*00501*859764129*0*T*:~ |
| GS*HC*SUBMITTER*RECEIVER*20260723*1200*1*X*005010X222A1~ |
| ST*837*0001*005010X222A1~ |
| BHT*0019*00*CLM603729*20260723*1200*CH~ |
| NM1*41*2*SYNTHETIC SUBMITTER*****46*683287464~ |
| NM1*40*2*SYNTHETIC RECEIVER*****46*483408855~ |
| CLM*CLM603729*150.00***11:B:1*Y*A*Y*Y~ |
| SE*7*0001~ |
| GE*1*859764129~ |
| IEA*1*859764129~" |
| 051489975,837P,CLM137254,"ISA*00* *00* *ZZ*SUBMITTER *ZZ*RECEIVER *20260515*1200*^*00501*051489975*0*T*:~ |
| GS*HC*SUBMITTER*RECEIVER*20260515*1200*1*X*005010X222A1~ |
| ST*837*0001*005010X222A1~ |
| BHT*0019*00*CLM137254*20260515*1200*CH~ |
| NM1*41*2*SYNTHETIC SUBMITTER*****46*225629177~ |
| NM1*40*2*SYNTHETIC RECEIVER*****46*676284125~ |
| CLM*CLM137254*150.00***11:B:1*Y*A*Y*Y~ |
| SE*7*0001~ |
| GE*1*051489975~ |
| IEA*1*051489975~" |
|
|
