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GS*HS*45282*45282*260428*1604*1487113239*X*005010X279A1~
ST*270*000044560*005010X279A1~
BHT*0022*13*000044560*2604118*1604~
HL*1**20*1~
NM1*PR*2*UNIVERSITY OF MD HEALTH ADVANTAGE*****PI*45282~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*REINHARDT*ELLEN****MI*mxj916792002~
DMG*D8*19470313*F~
DTP*291*RD8*20260428-20260727~
EQ*42~
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SE*14*000044560~
GE*1*44560~
IEA*1*000044560~