ISA*00*          *00*          *ZZ*xxxxx          *ZZ*Gil Messick    *260316*1003*^*00501*000042422*0*P*>~
GS*HS*Gil Messick*Gil Messick*260316*1003*1487113239*X*005010X279A1~
ST*270*000042422*005010X279A1~
BHT*0022*13*000042422*260375*1003~
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*PEARSON*ALFONSO****MI*81100238550~
DMG*D8*19680513*M~
DTP*291*RD8*20260316-20260614~
EQ*42~
EQ*30~
SE*14*000042422~
GE*1*42422~
IEA*1*000042422~

