Sha256: 293146c8cc66a504ed4fa35ee3cfaa7cf022eff051b48d963250d44cef73b4db
Contents?: true
Size: 730 Bytes
Versions: 12
Compression:
Stored size: 730 Bytes
Contents
ST*835*1234~ BPR*I*1922.86*C*CHK************20110108~ TRN*1*02790758*560894904~ REF*F2*LCLA438D~ DTM*405*20110104~ N1*PR*BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA~ N3*P O BOX 2291~ N4*DURHAM*NC*27702~ PER*CX*TE*8005554844~ N1*PE*XYZ HEALTHCARE CORPORATION*XX*0987654321~ N3*P O BOX XYZ~ N4*CHARLOTTE*NC*28234~ REF*TJ*123456789~ LX*1~ CLP*200200964A52*1*2100*1922.86*142.54*15*94151100100~ NM1*QC*1*Dough*Mary****MI* YPB123456789001~ DTM*050*20110103~ SVC*HC:59430*1210*1057.86**1*HC:59410~ DTM*472*20101231~ CAS*CO*42*34.6~ CAS*PR*2*117.54~ REF*6R*0001~ AMT*B6*1175.4~ SVC*HC:59440*890*865**1*HC:59410~ DTM*472*20101231~ CAS*PR*3*25~ REF*6R*0002~ SVC*HC:59426*742*742**1~ DTM*472*20101231~ REF*6R*0003~ AMT*B6*742~ SE*33*1234~
Version data entries
12 entries across 12 versions & 1 rubygems