ISA*00*          *00*          *ZZ*10353          *ZZ*10353          *250919*1109*^*00501*000000599*0*P*>~
GS*HS*10353*10353*250919*1109*1073904009*X*005010X279A1~
ST*270*000000599*005010X279A1~
BHT*0022*13*000000599*2509262*1109~
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*CROSBY*MARK****MI*H96126524~
DMG*D8*19550703*M~
DTP*291*RD8*20250919-20251218~
EQ*42~
EQ*30~
SE*14*000000599~
GE*1*599~
IEA*1*000000599~

