ISA*00*          *00*          *ZZ*15004          *ZZ*15004          *250815*1608*^*00501*000030943*0*P*>~
GS*HS*15004*15004*250815*1608*1487113239*X*005010X279A1~
ST*270*000030943*005010X279A1~
BHT*0022*13*000030943*2508227*1608~
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*NICHOLSON*CARLOS****MI*5V94X55FN80~
DMG*D8*19660828*M~
DTP*291*RD8*20250815-20251113~
EQ*42~
EQ*30~
SE*14*000030943~
GE*1*30943~
IEA*1*000030943~