ISA*00*          *00*          *ZZ*10353          *ZZ*10353          *250827*1608*^*00501*000000461*0*P*>~
GS*HS*10353*10353*250827*1608*1073904009*X*005010X279A1~
ST*270*000000461*005010X279A1~
BHT*0022*13*000000461*2508239*1608~
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*ESSIAW*TERESA****MI*H57408515~
DMG*D8*19480617*F~
DTP*291*RD8*20250827-20251125~
EQ*42~
EQ*30~
SE*14*000000461~
GE*1*461~
IEA*1*000000461~

