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GS*HS*Gil Messick*Gil Messick*260115*1001*1487113239*X*005010X279A1~
ST*270*000037883*005010X279A1~
BHT*0022*13*000037883*260115*1001~
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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*TAYLOR*TIMIKA****MI*30908108730~
DMG*D8*19750626*F~
DTP*291*RD8*20260115-20260415~
EQ*42~
EQ*30~
SE*14*000037883~
GE*1*37883~
IEA*1*000037883~