ISA*00*          *00*          *ZZ*10000          *ZZ*10000          *260713*1507*^*00501*000049039*0*P*>~
GS*HS*10000*10000*260713*1507*1487113239*X*005010X279A1~
ST*270*000049039*005010X279A1~
BHT*0022*13*000049039*2607194*1507~
HL*1**20*1~
NM1*PR*2*MEDICARE PPS*****PI*10000~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*HARPER*DIANNE****MI*2RG3W77WG19~
DMG*D8*19540610*F~
DTP*291*RD8*20260713-20261011~
EQ*42~
EQ*30~
SE*14*000049039~
GE*1*49039~
IEA*1*000049039~

