ISA*00*          *00*          *ZZ*10353          *ZZ*10353          *250825*1108*^*00501*000000436*0*P*>~
GS*HS*10353*10353*250825*1108*1073904009*X*005010X279A1~
ST*270*000000436*005010X279A1~
BHT*0022*13*000000436*2508237*1108~
HL*1**20*1~
NM1*PR*2*HUMANA GOLD CHOICE*****PI*6013~
HL*2*1*21*1~
NM1*1P*2*GRACE HOME HEALTHCARE, LLC*****XX*1073904009~
HL*3*2*22*0~
NM1*IL*1*BRYAN*MYRA****MI*H86016775~
DMG*D8*19600117*F~
DTP*291*RD8*20250825-20251123~
EQ*42~
EQ*30~
SE*14*000000436~
GE*1*436~
IEA*1*000000436~

