ISA*00*          *00*          *ZZ*xxxxx          *ZZ*Gil Messick    *260615*1106*^*00501*000047693*0*P*>~
GS*HS*Gil Messick*Gil Messick*260615*1106*1487113239*X*005010X279A1~
ST*270*000047693*005010X279A1~
BHT*0022*13*000047693*2606166*1106~
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*RIFFEE*DONNA****MI*47003381000~
DMG*D8*19620531*F~
DTP*291*RD8*20260615-20260913~
EQ*42~
EQ*30~
SE*14*000047693~
GE*1*47693~
IEA*1*000047693~

