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GS*HS*RP016*RP016*250815*1008*1487113239*X*005010X279A1~
ST*270*000030925*005010X279A1~
BHT*0022*13*000030925*2508227*1008~
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*SORRELL*RODGER****MI*AA00013183~
DMG*D8*19500907*M~
DTP*291*RD8*20250815-20251113~
EQ*42~
EQ*30~
SE*14*000030925~
GE*1*30925~
IEA*1*000030925~