C00096;TA111349;BCO3;1;138196;JAVIER LOPEZ-983;Advanced Medical-DENVER;230 W 6TH AVE;DENVER;CO;80204;06/04/25
C00096;TA111349;469M130;1;138196;JAVIER LOPEZ-983;Advanced Medical-DENVER;230 W 6TH AVE;DENVER;CO;80204;06/04/25
C00096;TA111349;COMP;No
