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GS*HS*RP016*RP016*260107*1501*1487113239*X*005010X279A1~
ST*270*000038126*005010X279A1~
BHT*0022*13*000038126*260107*1501~
HL*1**20*1~
NM1*PR*2*ALTERWOOD HEALTH - EPISODIC*****PI*RP016~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*MCMANUS*CHARLES****MI*AA00016839~
DMG*D8*19420812*F~
DTP*291*RD8*20260107-20260407~
EQ*42~
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IEA*1*000038126~