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GS*HS*10000*10000*251231*1512*1487113239*X*005010X279A1~
ST*270*000023594*005010X279A1~
BHT*0022*13*000023594*2512365*1512~
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*BROWN*JEFFREY****MI*8RP5G71YX50~
DMG*D8*19550809*M~
DTP*291*RD8*20251231-20260331~
EQ*42~
EQ*30~
SE*14*000023594~
GE*1*23594~
IEA*1*000023594~