ISA*00*          *00*          *ZZ*10353          *ZZ*10353          *251003*0810*^*00501*000000660*0*P*>~
GS*HS*10353*10353*251003*0810*1073904009*X*005010X279A1~
ST*270*000000660*005010X279A1~
BHT*0022*13*000000660*2510276*0810~
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*SCHULTZ*ROBERT****MI*H75070180~
DMG*D8*19550724*M~
DTP*291*RD8*20251003-20260101~
EQ*42~
EQ*30~
SE*14*000000660~
GE*1*660~
IEA*1*000000660~