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GS*HS*RP016*RP016*260506*1205*1487113239*X*005010X279A1~
ST*270*000042370*005010X279A1~
BHT*0022*13*000042370*2605126*1205~
HL*1**20*1~
NM1*PR*2*ALTERWOOD HEALTH - EPISODIC*****PI*RP016~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*EVERETT*DEANNA****MI*AA00002206~
DMG*D8*19431220*F~
DTP*291*RD8*20260506-20260804~
EQ*42~
EQ*30~
SE*14*000042370~
GE*1*42370~
IEA*1*000042370~