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GS*HS*10000*10000*251208*0912*1487113239*X*005010X279A1~
ST*270*000037075*005010X279A1~
BHT*0022*13*000037075*2512342*0912~
HL*1**20*1~
NM1*PR*2*MEDICARE PPS*****PI*10000~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*WHITTLE*CHRISTINE****MI*1M29JM8CK48~
DMG*D8*19830613*F~
DTP*291*RD8*20251208-20260308~
EQ*42~
EQ*30~
SE*14*000037075~
GE*1*37075~
IEA*1*000037075~