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GS*HS*Gil Messick*Gil Messick*251229*1312*1487113239*X*005010X279A1~
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BHT*0022*13*000037877*2512363*1312~
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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*COARD*AMY****MI*03306233740~
DMG*D8*19741116*F~
DTP*291*RD8*20251229-20260329~
EQ*42~
EQ*30~
SE*14*000037877~
GE*1*37877~
IEA*1*000037877~