BHS^~|\&^VAMC 552^552^ESR^200ESR^20040810^^~T~ORU|Z07~2.3.1~AL~AL^^54364365^ 
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|114636~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~431321098~HONORABLE^19380101~20041020
ZMH^2^POW^Y~""^""~""
ZMH^3^COMB^Y~WORLD WAR II - EUROPE^
ZMH^4^LEBA^Y^19831010~19831110
ZMH^5^GREN^N^""~""
ZMH^6^PANA^N^""~""
ZMH^7^GULF^Y^
ZMH^8^SOMA^N^""~""
ZMH^9^PH^N~1~1^""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|114986~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|125153~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|138442~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|110272~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|142015~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|110096~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|109687~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|110076~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|109766~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|142047~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|142118~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|109523~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|120926~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|26093~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|138182~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|109321~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|109166~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|108747~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|141978~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|108847~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|108804~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|63248~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|56511~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|125277~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|72205~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|142129~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|36560~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|140317~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|64544~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|120890~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|142003~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|37883~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|33223~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|118585~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|31507~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|27187~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|64215~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|137090~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|58748~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|139558~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|128295~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|31356~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|130476~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|106382~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|142049~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|35279~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|142115~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|113930~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
MSH^~|\&^VAMC 552^552^ESR^200ESR^20030904121212-0500^^ORU~Z07^54364365-1^T^2.1^^^AL^AL^USA
PID^1^1000913833V082573^1000913833V082573~~~USVHA&&0363~NI~VA FACILITY ID&200M&L|130284~~~
USVHA&&0363~PI~VA FACILITY ID&500&L|000004834~~~USSSA&&0363~SS~VA FACILITY ID&500&L|666123456~~~USSSA&&0363~SS~VA FA
CILITY ID&500&L~~20060127|000123456~~~USSSA&&0363~SS~VA FACILITY ID&500&L~~20060127^^ESRPATIENT~FNAME~X~~~^^19270101^M^^^557 OREGONS~""~LITTLE FALLS~NY~13333-1633~USA~VACAE~STE 322~~~~20020125&20060125|3400 EDS DRIVE~""~HERNDON~VA~20171-1633~USA~P~STE 322~~~~20020125&20060125^^
(999)123-0001~PRN~PH|(999)123-0002~WPN~PH|(999)123-0003~ORN~CP|(999)123-0004~BPN~BP|~NET~INTERNET~EMAIL@FOO.COM^(999)123-0005X3464
^^^^^134673732
PD1^^^DAYTON~~552
ZPD^1^^^^^^^0^""^^0^0^199109030832-0500^^^^U^^0^^^^^^^^^^^^""^""^""^^""^^^^^""
ZTA^1^Y^20050321^20050416^64 NEW ENGLAND~""~BIG FALLS~NY~13333-1633~USA~~STE 153^043^(800)934-7534^20041019164937-0400^552
ZIE^1^""^""^^
ZEL^1^5^^^""^16947665^376ST LOUIS RPC^1^^V^20030618^^VIVA^0^0^0^0^0^0^0^0^""^N^20020404133414-0500^552^^^^""^^^^^20050000^552^^0^""^""^""
ZEN^1^19981029^1^1^""^""^552^552^""^20060308^19981029^""^""
ZCD^1^""^""^""^""^""^""^""^""^""^""^""^""^""^""^""
ZMH^1^SL^ARMY~35530645~HONORABLE^19430119~19520700
ZMH^2^POW^U~""^""~""
ZMH^3^COMB^N~""^""~""
ZMH^4^VIET^N^""~""
ZMH^5^LEBA^N^""~""
ZMH^6^GREN^N^""~""
ZMH^7^PANA^N^""~""
ZMH^8^GULF^N^""~""
ZMH^9^SOMA^N^""~""
ZRD^1^^^
ZCT^1^1^ESRWIFE~FNAME~~~~~L^WIFE^PO BOX 1534~112 ELM STREET~HEBRON~OH~430251534^(666)666-5296^""^^^""
ZEM^1^1^5^^^^^
ZEM^2^2^3^^^^^
ZGD^1^1^""^""^""^""^""^""
ZGD^1^2^""^""^""^""^""^""
ZIC^1^20050000^2000^^^^^^25000^^^5000^334.55^1000^2000^5000^^2500^1500^
ZIR^1^1^1^""^0^^^^^""^^^^
ZDP^1^ESRWIFE~FNAME^F^19200715^276322899^2^23395^""^19511221^""
ZIC^1^20050000^1000^^^^^^15000^^^2000^^^^10000^^2000^1000^
ZIR^1^""^""^^^^^^^^^^^
ZIO^1^0^0^20050224^""^""
NTE^1^^:A MEANS TEST was edited on Mar 09, 2006 9:41:45 am with data inconsistencies.
NTE^2^^: Incorrect means test status for Test-Determined Status
IN1^1^^^MEDICARE (WNR)^""^^(800)784-2335^PART A^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
IN1^2^^^MEDICARE (WNR)^""^^(800)784-2335^PART B^MEDICARE^^^19871101^""^^33^JUNIPER,ROBERT A SR^v^^^^^^^^^^^^^^^^^^^274123938A
ZMT^1^20060308^C^50000^22000^""^1^32285^3334.55^20060309^""^1^""^""^""^""^1^1^^^""^552^^^20060309094145-0500^C^^40950^^1
ZMT^2^^^^^^^^^^^^^^^^^^^^^
ZMT^4^^^^^^^^^^^^^^^^^^^^^
ZBT^1
ZSP^1^0^""^2^N^0^0^""^^""
RF1^^^SAD^^^552~USVAMC^20060309101714-0500^^^
BTS^1