      000000000ST  0000                                               
2000A 000236931HL  00011           201005010X222A1
2010AA000000002NM1 000185 2TAOS CLINIC FOR CHILDREN & YOUTH                                                                                                  XX1154350205                                                                      
2010AA000000002N3  00011393 WEIMER RD                                                                                                
2010AA000000002N4  0001TAOS                          NM875716253            
2010AA000000002REF 0001EI 850403189                                         
2010AA000000002PER 0001ICPolaris                                                     TE8778013506                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
2000B 000000002HL  00012           1           220
2000B 000000002SBR 0001P18488295                                                                                                           MA
2010BA000000002NM1 0001IL 1Dhavileswarapu                                              Sailaja                                                               MI111123456                                                                       
2010BA000000002N3  000112345 Nowhere Street                                                                                          
2010BA000000002N4  0001TAOS                          NM87571                
2010BA000000002DMG 0001D8 19800101F
2010BA000000002REF 0001SY 111123456                                         
2010BB000000002NM1 0001PR 2UNITED HEALTHCARE SERVICES, INC                             PI87726                                                                           
2010BB000000002N3  0001PO BOX 30555                                                                                                  
2010BB000000002N4  0001SALT LAKE CITY                UT841300555            
2300  000000002CLM 0001E1047044761                           00000000000002500{11B 1YAYY                     
2300  000236931UFE 0001I7EN                                                                                 00000    0014105                                                                         HCFAJ6 #SH1PSES111111999    N0000000000000000                              N 0                                                          1009962541            00000    08 CH981150723693300  22                   HCFAJ6         000000000
2300  000000002REF 0001D9 20151120                                          
2300  000000002REF 0002EA 901528447                                         
2300  000000002NTE 0001ADD20151120                                                                        
2300  000000002HI  0001ABKE1101                                                                                                                                                                                                                                                                                                                                                                                                    
2310B 000000002NM1 000182 1Bushnell                                                    Lisa                                                                  XX1174524912                                                                      
2310C 000000002NM1 000277 2TAOS CLINIC FOR CHILDREN & YOUTH                                                                                                                                       
2310C 000000002N3  00011393 WEIMER RD                                                                                                
2310C 000000002N4  0001Taos                          NM875716253            
2400  000000002LX  000100000A
2400  000000002SV1 0001HC99211                                                                                                                                   00000000000002500{UN00000000000000100{  0A0{0{0{   0
2400  000000002DTP 0001472RD82016020820160208
      000000000SE  0000000000000{         
