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GS*HS*RP016*RP016*260707*1107*1487113239*X*005010X279A1~
ST*270*000047941*005010X279A1~
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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*BUTLER*MELVIN****MI*AA00022350~
DMG*D8*19400318*M~
DTP*291*RD8*20260707-20261005~
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IEA*1*000047941~