ISA*00*          *00*          *ZZ*10000          *ZZ*10000          *251210*1712*^*00501*000036346*0*P*>~
GS*HS*10000*10000*251210*1712*1487113239*X*005010X279A1~
ST*270*000036346*005010X279A1~
BHT*0022*13*000036346*2512344*1712~
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*FICKUS*DIANE****MI*1KW3T27VH11~
DMG*D8*19490708*F~
DTP*291*RD8*20251210-20260310~
EQ*42~
EQ*30~
SE*14*000036346~
GE*1*36346~
IEA*1*000036346~

