ISA*00*          *00*          *ZZ*               *ZZ*               *250815*1408*^*00501*000000402*0*P*>~
GS*HS***250815*1408*1073904009*X*005010X279A1~
ST*270*000000402*005010X279A1~
BHT*0022*13*000000402*2508227*1408~
HL*1**20*1~
NM1*PR*2*ANTHEM MEDICARE ADVANTAGE*****PI*10115~
HL*2*1*21*1~
NM1*1P*2*GRACE HOME HEALTHCARE, LLC*****XX*1073904009~
HL*3*2*22*0~
NM1*IL*1*PENCEAL*SHARON****MI*YTW847W09801~
DMG*D8*19560829*M~
DTP*291*RD8*20250815-20251113~
EQ*42~
EQ*30~
SE*14*000000402~
GE*1*402~
IEA*1*000000402~