ISA*00*          *00*          *ZZ*10000          *ZZ*10000          *260408*1604*^*00501*000043764*0*P*>~
GS*HS*10000*10000*260408*1604*1487113239*X*005010X279A1~
ST*270*000043764*005010X279A1~
BHT*0022*13*000043764*260498*1604~
HL*1**20*1~
NM1*PR*2*MEDICARE PPS*****PI*10000~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*WILHELM*PATRICIA****MI*8TW0XE2QD47~
DMG*D8*19361221*F~
DTP*291*RD8*20260408-20260707~
EQ*42~
EQ*30~
SE*14*000043764~
GE*1*43764~
IEA*1*000043764~

