ISA*00*          *00*          *ZZ*xxxxx          *ZZ*Gil Messick    *250805*1208*^*00501*000030160*0*P*>~
GS*HS*Gil Messick*Gil Messick*250805*1208*1487113239*X*005010X279A1~
ST*270*000030160*005010X279A1~
BHT*0022*13*000030160*2508217*1208~
HL*1**20*1~
NM1*PR*2*MEDICAID*****PI*2~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*KULIS*MARIA****MI*41800870700~
DMG*D8*19450407*F~
DTP*291*RD8*20250805-20251103~
EQ*42~
EQ*30~
SE*14*000030160~
GE*1*30160~
IEA*1*000030160~

