ISA*00*          *00*          *ZZ*10000          *ZZ*10000          *250813*1108*^*00501*000030830*0*P*>~
GS*HS*10000*10000*250813*1108*1487113239*X*005010X279A1~
ST*270*000030830*005010X279A1~
BHT*0022*13*000030830*2508225*1108~
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*NIEVES*IRMA****MI*5FV6FW3RJ82~
DMG*D8*19500504*F~
DTP*291*RD8*20250813-20251111~
EQ*42~
EQ*30~
SE*14*000030830~
GE*1*30830~
IEA*1*000030830~