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GS*HS*15004*15004*250724*1607*1487113239*X*005010X279A1~
ST*270*000029681*005010X279A1~
BHT*0022*13*000029681*2507205*1607~
HL*1**20*1~
NM1*PR*2*MEDICARE*****PI*10000~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*PALMER*ALAN****MI*3U31E27VN92~
DMG*D8*19480811*F~
DTP*291*RD8*20250724-20251022~
EQ*42~
EQ*30~
SE*14*000029681~
GE*1*29681~
IEA*1*000029681~