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GS*HS*RP016*RP016*260914*1509*1487113239*X*005010X279A1~
ST*270*000050917*005010X279A1~
BHT*0022*13*000050917*2609257*1509~
HL*1**20*1~
NM1*PR*2*ALTERWOOD HEALTH - EPISODIC*****PI*RP016~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*DODD*RICHARD****MI*AA00010997~
DMG*D8*19550820*M~
DTP*291*RD8*20260914-20261213~
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IEA*1*000050917~