ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *250804*1508*^*00501*000000333*0*P*>~
GS*HS*52095*52095*250804*1508*1073904009*X*005010X279A1~
ST*270*000000333*005010X279A1~
BHT*0022*13*000000333*2508216*1508~
HL*1**20*1~
NM1*PR*2*KAISER PERMANENTE*****PI*10403~
HL*2*1*21*1~
NM1*1P*2*GRACE HOME HEALTHCARE, LLC*****XX*1073904009~
HL*3*2*22*0~
NM1*IL*1*FAULKNER*LYDIA****MI*28114279~
DMG*D8*19370102*F~
DTP*291*RD8*20250804-20251102~
EQ*42~
EQ*30~
SE*14*000000333~
GE*1*333~
IEA*1*000000333~