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GS*HS*10000*10000*260901*1609*1487113239*X*005010X279A1~
ST*270*000050341*005010X279A1~
BHT*0022*13*000050341*2609244*1609~
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*BEST*MARVIN****MI*1C87MA3WG32~
DMG*D8*19370419*M~
DTP*291*RD8*20260901-20261130~
EQ*42~
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GE*1*50341~
IEA*1*000050341~