ISA*00*          *00*          *ZZ*SKMD0          *ZZ*SKMD0          *260430*1504*^*00501*000044649*0*P*>~
GS*HS*SKMD0*SKMD0*260430*1504*1487113239*X*005010X279A1~
ST*270*000044649*005010X279A1~
BHT*0022*13*000044649*2604120*1504~
HL*1**20*1~
NM1*PR*2*MARYLAND MEDICAID*****PI*10448~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*JORDAN*DAVID****MI*40601036400~
DMG*D8*19740413*M~
DTP*291*RD8*20260430-20260729~
EQ*42~
EQ*30~
SE*14*000044649~
GE*1*44649~
IEA*1*000044649~

