ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *250911*1209*^*00501*000000567*0*P*>~
GS*HS*52095*52095*250911*1209*1073904009*X*005010X279A1~
ST*270*000000567*005010X279A1~
BHT*0022*13*000000567*2509254*1209~
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*ARAUJO*PAULA****MI*17191400~
DMG*D8*19760116*F~
DTP*291*RD8*20250911-20251210~
EQ*42~
EQ*30~
SE*14*000000567~
GE*1*567~
IEA*1*000000567~