ISA*00*          *00*          *ZZ*10000          *ZZ*10000          *251107*1111*^*00501*000030246*0*P*>~
GS*HS*10000*10000*251107*1111*1487113239*X*005010X279A1~
ST*270*000030246*005010X279A1~
BHT*0022*13*000030246*2511311*1111~
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*DAVIS*LARRY****MI*6RW2HH8UQ08~
DMG*D8*19491228*M~
DTP*291*RD8*20251107-20260205~
EQ*42~
EQ*30~
SE*14*000030246~
GE*1*30246~
IEA*1*000030246~