ISA*00*          *00*          *ZZ*10000          *ZZ*10000          *250930*1609*^*00501*000033061*0*P*>~
GS*HS*10000*10000*250930*1609*1487113239*X*005010X279A1~
ST*270*000033061*005010X279A1~
BHT*0022*13*000033061*2509273*1609~
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*SMITH DIXON*JEANNETTE****MI*7X92RW0NT01~
DMG*D8*19570523*F~
DTP*291*RD8*20250930-20251229~
EQ*42~
EQ*30~
SE*14*000033061~
GE*1*33061~
IEA*1*000033061~

