ISA*00*          *00*          *ZZ*15004          *ZZ*15004          *251204*1512*^*00501*000005301*0*P*>~
GS*HS*15004*15004*251204*1512*1487113239*X*005010X279A1~
ST*270*000005301*005010X279A1~
BHT*0022*13*000005301*2512338*1512~
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*WILSON*DARLENE****MI*5YT0UE4EC14~
DMG*D8*19560425*F~
DTP*291*RD8*20251204-20260304~
EQ*42~
EQ*30~
SE*14*000005301~
GE*1*5301~
IEA*1*000005301~