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GS*HS*RP016*RP016*250814*1408*1487113239*X*005010X279A1~
ST*270*000000000*005010X279A1~
BHT*0022*13*000000000*2508226*1408~
HL*1**20*1~
NM1*PR*2*ALTERWOOD HEALTH - EPISODIC*****PI*RP016~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*HANCOCK*AUDREY****MI*AA00003625~
DMG*D8*19481113*M~
DTP*291*RD8*20250814-20251112~
EQ*42~
EQ*30~
SE*14*000000000~
GE*1*~
IEA*1*000000000~