ISA*00*          *00*          *ZZ*10000          *ZZ*10000          *251113*1311*^*00501*000004021*0*P*>~
GS*HS*10000*10000*251113*1311*1487113239*X*005010X279A1~
ST*270*000004021*005010X279A1~
BHT*0022*13*000004021*2511317*1311~
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*CREEK*SOPHIA****MI*9F88T74KC47~
DMG*D8*19621125*F~
DTP*291*RD8*20251113-20260211~
EQ*42~
EQ*30~
SE*14*000004021~
GE*1*4021~
IEA*1*000004021~