ISA*00*          *00*          *ZZ*xxxxx          *ZZ*Gil Messick    *260506*1105*^*00501*000042490*0*P*>~
GS*HS*Gil Messick*Gil Messick*260506*1105*1487113239*X*005010X279A1~
ST*270*000042490*005010X279A1~
BHT*0022*13*000042490*2605126*1105~
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*GRIFFIN*VERNON****MI*3065308100~
DMG*D8*19610905*M~
DTP*291*RD8*20260506-20260804~
EQ*42~
EQ*30~
SE*14*000042490~
GE*1*42490~
IEA*1*000042490~

