ISA*00*          *00*          *ZZ*xxxxx          *ZZ*Gil Messick    *260403*1304*^*00501*000043077*0*P*>~
GS*HS*Gil Messick*Gil Messick*260403*1304*1487113239*X*005010X279A1~
ST*270*000043077*005010X279A1~
BHT*0022*13*000043077*260493*1304~
HL*1**20*1~
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*MORRIS*THERESA****MI*03193140670~
DMG*D8*19670115*F~
DTP*291*RD8*20260403-20260702~
EQ*42~
EQ*30~
SE*14*000043077~
GE*1*43077~
IEA*1*000043077~

