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GS*HS*15004*15004*251002*0910*1073904009*X*005010X279A1~
ST*270*000000649*005010X279A1~
BHT*0022*13*000000649*2510275*0910~
HL*1**20*1~
NM1*PR*2*MEDICARE PPS*****PI*10000~
HL*2*1*21*1~
NM1*1P*2*GRACE HOME HEALTHCARE, LLC*****XX*1073904009~
HL*3*2*22*0~
NM1*IL*1*HEREFORD*JAMES****MI*8KA6K22WY70~
DMG*D8*19470514*M~
DTP*291*RD8*20251002-20251231~
EQ*42~
EQ*30~
SE*14*000000649~
GE*1*649~
IEA*1*000000649~

