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GS*HS*Gil Messick*Gil Messick*260423*1004*1487113239*X*005010X279A1~
ST*270*000044391*005010X279A1~
BHT*0022*13*000044391*2604113*1004~
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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*SMITH*PATTIE****MI*42602684800~
DMG*D8*19530420*F~
DTP*291*RD8*20260423-20260722~
EQ*42~
EQ*30~
SE*14*000044391~
GE*1*44391~
IEA*1*000044391~