ISA*00*          *00*          *ZZ*10000          *ZZ*10000          *251006*1010*^*00501*000033304*0*P*>~
GS*HS*10000*10000*251006*1010*1487113239*X*005010X279A1~
ST*270*000033304*005010X279A1~
BHT*0022*13*000033304*2510279*1010~
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*MOSBY*ANNIE****MI*2V64KX7AD67~
DMG*D8*19430830*F~
DTP*291*RD8*20251006-20260104~
EQ*42~
EQ*30~
SE*14*000033304~
GE*1*33304~
IEA*1*000033304~