ISA*00*          *00*          *ZZ*xxxxx          *ZZ*Gil Messick    *260126*1301*^*00501*000039370*0*P*>~
GS*HS*Gil Messick*Gil Messick*260126*1301*1487113239*X*005010X279A1~
ST*270*000039370*005010X279A1~
BHT*0022*13*000039370*260126*1301~
HL*1**20*1~
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*TAVDIDISHVILI*RUTO****MI*30062163000~
DMG*D8*19380403*F~
DTP*291*RD8*20260126-20260426~
EQ*42~
EQ*30~
SE*14*000039370~
GE*1*39370~
IEA*1*000039370~

