ISA*00*          *00*          *ZZ*10085          *ZZ*10085          *251120*1611*^*00501*000036177*0*P*>~
GS*HS*10085*10085*251120*1611*1487113239*X*005010X279A1~
ST*270*000036177*005010X279A1~
BHT*0022*13*000036177*2511324*1611~
HL*1**20*1~
NM1*PR*2*CAREFIRST BC/BS DC*****PI*10085~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*HOHENTHANER*DIANN****MI*R50084316~
DMG*D8*19610222*F~
DTP*291*RD8*20251120-20260218~
EQ*42~
EQ*30~
SE*14*000036177~
GE*1*36177~
IEA*1*000036177~

