ISA*00*          *00*          *ZZ*10000          *ZZ*10000          *251107*1111*^*00501*000029749*0*P*>~
GS*HS*10000*10000*251107*1111*1487113239*X*005010X279A1~
ST*270*000029749*005010X279A1~
BHT*0022*13*000029749*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*TESLER*ZHANNA****MI*1P79PE8KP17~
DMG*D8*19340207*F~
DTP*291*RD8*20251107-20260205~
EQ*42~
EQ*30~
SE*14*000029749~
GE*1*29749~
IEA*1*000029749~