ISA*00*          *00*          *ZZ*xxxxx          *ZZ*Gil Messick    *251214*1112*^*00501*000037483*0*P*>~
GS*HS*Gil Messick*Gil Messick*251214*1112*1487113239*X*005010X279A1~
ST*270*000037483*005010X279A1~
BHT*0022*13*000037483*2512348*1112~
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*DOUGHTY*DELORES****MI*30882800000~
DMG*D8*19480208*F~
DTP*291*RD8*20251214-20260314~
EQ*42~
EQ*30~
SE*14*000037483~
GE*1*37483~
IEA*1*000037483~

