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GS*HS*10000*10000*250822*1308*1487113239*X*005010X279A1~
ST*270*000031215*005010X279A1~
BHT*0022*13*000031215*2508234*1308~
HL*1**20*1~
NM1*PR*2*MEDICARE PPS*****PI*10000~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*IZAGUIRRE*SONIA****MI*2CP0H87WY10~
DMG*D8*19420725*F~
DTP*291*RD8*20250822-20251120~
EQ*42~
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IEA*1*000031215~