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GS*HS*RP016*RP016*260515*1105*1487113239*X*005010X279A1~
ST*270*000045924*005010X279A1~
BHT*0022*13*000045924*2605135*1105~
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*BRYAN*MARILYN****MI*AA00017042~
DMG*D8*19530706*F~
DTP*291*RD8*20260515-20260813~
EQ*42~
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GE*1*45924~
IEA*1*000045924~