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GS*HS*10000*10000*260106*1601*1487113239*X*005010X279A1~
ST*270*000037025*005010X279A1~
BHT*0022*13*000037025*260106*1601~
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*SHEINBACH*GERALD****MI*3JR1AG8PR35~
DMG*D8*19310415*M~
DTP*291*RD8*20260106-20260406~
EQ*42~
EQ*30~
SE*14*000037025~
GE*1*37025~
IEA*1*000037025~