ISA*00*          *00*          *ZZ*10000          *ZZ*10000          *260903*1309*^*00501*000050393*0*P*>~
GS*HS*10000*10000*260903*1309*1487113239*X*005010X279A1~
ST*270*000050393*005010X279A1~
BHT*0022*13*000050393*2609246*1309~
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*FISKE*ALBERT****MI*5J43A80TT07~
DMG*D8*19461225*M~
DTP*291*RD8*20260903-20261202~
EQ*42~
EQ*30~
SE*14*000050393~
GE*1*50393~
IEA*1*000050393~

