ISA*00*          *00*          *ZZ*10000          *ZZ*10000          *260723*1207*^*00501*000049352*0*P*>~
GS*HS*10000*10000*260723*1207*1487113239*X*005010X279A1~
ST*270*000049352*005010X279A1~
BHT*0022*13*000049352*2607204*1207~
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*WUJEK*TERRY****MI*8MV5JJ4DT89~
DMG*D8*19530104*M~
DTP*291*RD8*20260723-20261021~
EQ*42~
EQ*30~
SE*14*000049352~
GE*1*49352~
IEA*1*000049352~