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sample.edi
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sample.edi
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ISA*01*0000000000*01*0000000000*ZZ*ABCDEFGHIJKLMNO*ZZ*123456789012345*101127*1719*U*00400*000003438*0*P*>
GS*HP*ABCCOM*01017*20110315*1005*1*X*004010X091A1
ST*835*07504123
BPR*H*5.75*C*NON************20110315
TRN*1*A04B001017.07504*1346000128
DTM*405*20110308
N1*PR*ASHTABULA COUNTY ADAMH BD*XX*6457839886
N3*4817 STATE ROAD SUITE 203
N4*ASHTABULA*OH*44004
N1*PE*LAKE AREA RECOVERY CENTER *FI*346608640
N3*2801 C. COURT
N4*ASHTABULA*OH*44004
REF*PQ*1017
LX*1
CLP*444444*1*56.70*56.52*0*MC*0000000655555555*53
NM1*QC*1*FUDD*ELMER*S***MI*1333333
NM1*82*2*WECOVERWY SVCS*****FI*346608640
REF*F8*A76B04054
SVC*HC:H0005:HF:H9*56.70*56.52**6
DTM*472*20110205
CAS*CO*42*0.18*0
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CLP*999999*4*25.95*0*25.95*13*0000000555555555*11
NM1*QC*1*SAM*YOSEMITE*A***MI*3333333
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NM1*QC*1*SQUAREPANTS*BOB* ***MI*2222222
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NM1*QC*1*LEGHORN*FOGHORN*P***MI*7777777
NM1*82*2*CHICKENHAWK SVCS*****FI*346608640
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NM1*QC*1*EXPLORER*DORA****MI*1717171
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GE*1*1
IEA*1*004075123