ISA*00*          *00*          *ZZ*1487113239     *ZZ*87726          *251028*1410*^*00501*000000813*0*P*>~
GS*HS*87726*87726*251028*1410*1073904009*X*005010X279A1~
ST*270*000000813*005010X279A1~
BHT*0022*13*000000813*2510301*1410~
HL*1**20*1~
NM1*PR*2*UNITED HEALTH CARE INCL UMR*****PI*87726~
HL*2*1*21*1~
NM1*1P*2*GRACE HOME HEALTHCARE, LLC*****XX*1073904009~
HL*3*2*22*0~
NM1*IL*1*PARK*CHARLES****MI*A296229784~
DMG*D8*19310313*M~
DTP*291*RD8*20251028-20260126~
EQ*42~
EQ*30~
SE*14*000000813~
GE*1*813~
IEA*1*000000813~