ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *251021*1810*^*00501*000000776*0*P*>~
GS*HS*52095*52095*251021*1810*1073904009*X*005010X279A1~
ST*270*000000776*005010X279A1~
BHT*0022*13*000000776*2510294*1810~
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*JOHNSON*CATHERINE****MI*14114144~
DMG*D8*19500824*F~
DTP*291*RD8*20251021-20260119~
EQ*42~
EQ*30~
SE*14*000000776~
GE*1*776~
IEA*1*000000776~