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GS*HS*RP016*RP016*260420*0904*1487113239*X*005010X279A1~
ST*270*000044241*005010X279A1~
BHT*0022*13*000044241*2604110*0904~
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*WALLACE-HICKS*MICHELLE****MI*A00025561~
DMG*D8*19680826*F~
DTP*291*RD8*20260420-20260719~
EQ*42~
EQ*30~
SE*14*000044241~
GE*1*44241~
IEA*1*000044241~