ISA*00*          *00*          *ZZ*xxxxx          *ZZ*Gil Messick    *251124*2111*^*00501*000036307*0*P*>~
GS*HS*Gil Messick*Gil Messick*251124*2111*1487113239*X*005010X279A1~
ST*270*000036307*005010X279A1~
BHT*0022*13*000036307*2511328*2111~
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*KHSAWNEH*HUSSEIN****MI*11349646240~
DMG*D8*19871210*M~
DTP*291*RD8*20251124-20260222~
EQ*42~
EQ*30~
SE*14*000036307~
GE*1*36307~
IEA*1*000036307~

