ISA*00*          *00*          *ZZ*xxxxx          *ZZ*Gil Messick    *250820*1008*^*00501*000031109*0*P*>~
GS*HS*Gil Messick*Gil Messick*250820*1008*1487113239*X*005010X279A1~
ST*270*000031109*005010X279A1~
BHT*0022*13*000031109*2508232*1008~
HL*1**20*1~
NM1*PR*2*MEDICAID*****PI*2~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*BOWMAN*DIANA****MI*45402064400~
DMG*D8*19690103*F~
DTP*291*RD8*20250820-20251118~
EQ*42~
EQ*30~
SE*14*000031109~
GE*1*31109~
IEA*1*000031109~

