ISA*00*          *00*          *ZZ*15004          *ZZ*15004          *250725*1707*^*00501*000029749*0*P*>~
GS*HS*15004*15004*250725*1707*1487113239*X*005010X279A1~
ST*270*000029749*005010X279A1~
BHT*0022*13*000029749*2507206*1707~
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*TESLER*ZHANNA****MI*1P79PE8KP17~
DMG*D8*19340207*F~
DTP*291*RD8*20250725-20251023~
EQ*42~
EQ*30~
SE*14*000029749~
GE*1*29749~
IEA*1*000029749~