ISA*00*          *00*          *ZZ*15004          *ZZ*15004          *251120*1011*^*00501*000006858*0*P*>~
GS*HS*15004*15004*251120*1011*1487113239*X*005010X279A1~
ST*270*000006858*005010X279A1~
BHT*0022*13*000006858*2511324*1011~
HL*1**20*1~
NM1*PR*2*MEDICARE*****PI*10000~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*DIXON*WILLIE****MI*1XC4H33UU95~
DMG*D8*19550813*M~
DTP*291*RD8*20251120-20260218~
EQ*42~
EQ*30~
SE*14*000006858~
GE*1*6858~
IEA*1*000006858~