<Confirmation SAM2_Number="43094907904" ISA_06="43094907904"><Claim Claim_ID="1111111" DMH_ID="123456" ConsumerName="BERHORST, HOPE"><Service SVC_ID="1" DateOfService="20060810" BilledAmt="123.37" Return_Acc_Rej="Rejected" Error_Desc="Consumer does not have an episode of care with the billing provider on date of service." /></Claim><Claim Claim_ID="111112" DMH_ID="123456" ConsumerName="BERHORST, HOPE"><Service SVC_ID="1" DateOfService="20060810" BilledAmt="12.44" Return_Acc_Rej="Rejected" Error_Desc="Consumer does not have an episode of care with the billing provider on date of service." /></Claim><Claim Claim_ID="1111113" DMH_ID="123456" ConsumerName="BERHORST, HOPE"><Service SVC_ID="1" DateOfService="20060814" BilledAmt="49.76" Return_Acc_Rej="Rejected" Error_Desc="Consumer does not have an episode of care with the billing provider on date of service." /></Claim><Claim Claim_ID="1111114" DMH_ID="654321" ConsumerName="DOE, JOHN"><Service SVC_ID="1" DateOfService="20060804" BilledAmt="85.74" Return_Acc_Rej="Rejected" Error_Desc="Consumer does not have an episode of care with the billing provider on date of service." /></Claim><Claim Claim_ID="1111115" DMH_ID="654321" ConsumerName="DOE, JOHN"><Service SVC_ID="1" DateOfService="20060805" BilledAmt="85.74" Return_Acc_Rej="Rejected" Error_Desc="Consumer does not have an episode of care with the billing provider on date of service." /></Claim></Confirmation>