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GS*HS*Gil Messick*Gil Messick*260326*1403*1487113239*X*005010X279A1~
ST*270*000042807*005010X279A1~
BHT*0022*13*000042807*260385*1403~
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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*JONES*LAWRENCE****MI*43101688000~
DMG*D8*19730804*M~
DTP*291*RD8*20260326-20260624~
EQ*42~
EQ*30~
SE*14*000042807~
GE*1*42807~
IEA*1*000042807~