ISA*00*          *00*          *ZZ*3900           *ZZ*98999          *080920*0847*U*00401*000000001*1*P*:~
GS*HC*3900*98999*20080920*0847*1*X*004010X098A1~
ST*837*0001~
BHT*0019*00*20080920084752*20080920*0847*CH~
REF*87*004010X098A1~
NM1*41*2*NEW RIVER SERVICE AUTHORITY*****46*98999~
PER*IC*MARTHA MORETZ*TE*8282635606~
NM1*40*2*SMOKY MOUNTAIN CENTER*****46*3900~
HL*1**20*1~
PRV*BI*ZZ*261QM1300X~
NM1*85*2*NEW RIVER BHC*****24*98999~
N3*895 STATE FARM RD.STE 508~
N4*BOONE*NC*286074917~
REF*0B*8301675~
HL*2*1*22*0~
SBR*F*18*******MC~
NM1*IL*1*DOE*JOHN****MI*064891~
N3*PO BOX 3~
N4*SYLVA*NC*28779~
DMG*D8*19801014*M~
NM1*PR*2*SMC MH/DD/SAS*****PI*3900~
N3*PO BOX 127~
N4*SYLVA*NC*28779~
CLM*064891*135***53::1*Y*A*Y*M*B~
REF*EA*064891~
NTE*ADD*2:40~
HI*BK:30520*BF:30550*BF:30440~
NM1*82*1*M DAVIS*****24*1083774269~
REF*0B*8301675Q~
NM1*77*2*NEW RIVER BEHAVIORAL HEALTHCARE*****24*1255476271~
N3*636 CRANBERRY ST~
N4*NEWLAND*NC*286570040~
LX*1~
SV1*HC:H0015*135*UN*1*11**1~
DTP*472*RD8*20080811-20080811~
CN1*09*5050~
REF*6R*20080920084700001~
NTE*ADD*3:00~
HL*3*1*22*0~
SBR*F*18*******MC~
NM1*IL*1*DOE*JANE****MI*151100~
N3*PO BOX 11~
N4*SYLVA*NC*28779~
DMG*D8*19720710*F~
NM1*PR*2*SMC MH/DD/SAS*****PI*3900~
N3*PO BOX 127~
N4*SYLVA*NC*28779~
CLM*151100*135***53::1*Y*A*Y*M*B~
REF*EA*151132~
NTE*ADD*1:50~
HI*BK:30440*BF:30981*BF:30400~
NM1*82*1*M DAVIS*****24*1083774269~
REF*0B*8301675Q~
NM1*77*2*NEW RIVER BEHAVIORAL HEALTHCARE*****24*1255476271~
N3*636 CRANBERRY ST~
N4*NEWLAND*NC*286570040~
LX*1~
SV1*HC:H0015*135*UN*1*11**1~
DTP*472*RD8*20080811-20080811~
CN1*09*5050~
REF*6R*20080920084700002~
NTE*ADD*3:00~
SE*65*0001~
GE*1*1~
IEA*1*000000001~