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GS*HS*10000*10000*251222*1412*1487113239*X*005010X279A1~
ST*270*000037733*005010X279A1~
BHT*0022*13*000037733*2512356*1412~
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*MERZ*ROBERT****MI*8CM6AK1XF62~
DMG*D8*19541103*M~
DTP*291*RD8*20251222-20260322~
EQ*42~
EQ*30~
SE*14*000037733~
GE*1*37733~
IEA*1*000037733~