ADV0000 A0001 Medicare 123456AF 123456AF 22/05/2025 986.3 986.3 0101 1111 181 Test Test 2111-11111-1 56220 21/05/2025 250.60 250.60 0.00 0301 1111 181 Test Test 2111-11111-1 57509 21/05/2025 42.35 42.35 0.00 0302 1111 181 Test Test 2111-11111-1 57509 21/05/2025 37.60 37.60 0.00 154 Diagnostic imaging multiple service rule applied to service 0501 1111 181 Test Test 2111-11111-1 57703 22/05/2025 57.55 57.55 0.00 0401 1111 181 Test Test 2111-11111-1 55274 22/05/2025 180.60 180.60 0.00 0201 1111 181 Test Test 2111-11111-1 56307 20/05/2025 417.60 417.60 0.00