ISA*00*          *00*          *ZZ*xxxxx          *ZZ*Gil Messick    *251112*1311*^*00501*000029253*0*P*>~
GS*HS*Gil Messick*Gil Messick*251112*1311*1487113239*X*005010X279A1~
ST*270*000029253*005010X279A1~
BHT*0022*13*000029253*2511316*1311~
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*HAWKINS*MILDRED****MI*43702542400~
DMG*D8*19450626*F~
DTP*291*RD8*20251112-20260210~
EQ*42~
EQ*30~
SE*14*000029253~
GE*1*29253~
IEA*1*000029253~

