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GS*HS*15004*15004*250918*1709*1487113239*X*005010X279A1~
ST*270*000032596*005010X279A1~
BHT*0022*13*000032596*2509261*1709~
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*MARQUES*CAROL****MI*8XU2ED3EM93~
DMG*D8*19520309*F~
DTP*291*RD8*20250918-20251217~
EQ*42~
EQ*30~
SE*14*000032596~
GE*1*32596~
IEA*1*000032596~