ISA*00*          *00*          *ZZ*10000          *ZZ*10000          *251211*1012*^*00501*000037367*0*P*>~
GS*HS*10000*10000*251211*1012*1487113239*X*005010X279A1~
ST*270*000037367*005010X279A1~
BHT*0022*13*000037367*2512345*1012~
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*ROTH*MELODY****MI*8F10C67YA39~
DMG*D8*19511030*F~
DTP*291*RD8*20251211-20260311~
EQ*42~
EQ*30~
SE*14*000037367~
GE*1*37367~
IEA*1*000037367~