ISA*00*          *00*          *ZZ*xxxxx          *ZZ*Gil Messick    *251031*1410*^*00501*000034825*0*P*>~
GS*HS*Gil Messick*Gil Messick*251031*1410*1487113239*X*005010X279A1~
ST*270*000034825*005010X279A1~
BHT*0022*13*000034825*2510304*1410~
HL*1**20*1~
NM1*PR*2*MEDICAID*****PI*2~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*TODD*BRIDGET****MI*16335682640~
DMG*D8*19640420*F~
DTP*291*RD8*20251031-20260129~
EQ*42~
EQ*30~
SE*14*000034825~
GE*1*34825~
IEA*1*000034825~

