ISA*00*          *00*          *ZZ*xxxxx          *ZZ*Gil Messick    *251121*1411*^*00501*000036222*0*P*>~
GS*HS*Gil Messick*Gil Messick*251121*1411*1487113239*X*005010X279A1~
ST*270*000036222*005010X279A1~
BHT*0022*13*000036222*2511325*1411~
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*WOMACK*YVETTE****MI*30468465570~
DMG*D8*19571130*F~
DTP*291*RD8*20251121-20260219~
EQ*42~
EQ*30~
SE*14*000036222~
GE*1*36222~
IEA*1*000036222~

