ISA*00*          *00*          *ZZ*15004          *ZZ*15004          *250815*1208*^*00501*000030935*0*P*>~
GS*HS*15004*15004*250815*1208*1487113239*X*005010X279A1~
ST*270*000030935*005010X279A1~
BHT*0022*13*000030935*2508227*1208~
HL*1**20*1~
NM1*PR*2*MEDICARE*****PI*10000~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*FAX*TEST****MI*5A97T15GD69~
DMG*D8*19600815*M~
DTP*291*RD8*20250815-20251113~
EQ*42~
EQ*30~
SE*14*000030935~
GE*1*30935~
IEA*1*000030935~