ISA*00*          *00*          *ZZ*xxxxx          *ZZ*Gil Messick    *260914*0809*^*00501*000050878*0*P*>~
GS*HS*Gil Messick*Gil Messick*260914*0809*1487113239*X*005010X279A1~
ST*270*000050878*005010X279A1~
BHT*0022*13*000050878*2609257*0809~
HL*1**20*1~
NM1*PR*2*MEDICAID*****PI*2~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*SIMMONS*MARY****MI*5196875200~
DMG*D8*19690930*F~
DTP*291*RD8*20260914-20261213~
EQ*42~
EQ*30~
SE*14*000050878~
GE*1*50878~
IEA*1*000050878~

