ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *251006*1610*^*00501*000000709*0*P*>~
GS*HS*52095*52095*251006*1610*1073904009*X*005010X279A1~
ST*270*000000709*005010X279A1~
BHT*0022*13*000000709*2510279*1610~
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*DOVEL*CAROLYN****MI*01087901~
DMG*D8*19461124*F~
DTP*291*RD8*20251006-20260104~
EQ*42~
EQ*30~
SE*14*000000709~
GE*1*709~
IEA*1*000000709~