ISA*00*          *00*          *ZZ*10000          *ZZ*10000          *250805*1708*^*00501*000030159*0*P*>~
GS*HS*10000*10000*250805*1708*1487113239*X*005010X279A1~
ST*270*000030159*005010X279A1~
BHT*0022*13*000030159*2508217*1708~
HL*1**20*1~
NM1*PR*2*MEDICARE PPS*****PI*10000~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*KULIS*MARIA****MI*6HW5U53FC97~
DMG*D8*19450407*F~
DTP*291*RD8*20250805-20251103~
EQ*42~
EQ*30~
SE*14*000030159~
GE*1*30159~
IEA*1*000030159~

