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GS*HS*RP016*RP016*250921*1109*1487113239*X*005010X279A1~
ST*270*000032660*005010X279A1~
BHT*0022*13*000032660*2509264*1109~
HL*1**20*1~
NM1*PR*2*ALTERWOOD HEALTH - EPISODIC*****PI*RP016~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*ZISSIMOS*JOAN****MI*unknown ~
DMG*D8*19411019*F~
DTP*291*RD8*20250921-20251220~
EQ*42~
EQ*30~
SE*14*000032660~
GE*1*32660~
IEA*1*000032660~