ISA*00*          *00*          *ZZ*10353          *ZZ*10353          *251030*1610*^*00501*000000827*0*P*>~
GS*HS*10353*10353*251030*1610*1073904009*X*005010X279A1~
ST*270*000000827*005010X279A1~
BHT*0022*13*000000827*2510303*1610~
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*SHIELDS*WARREN****MI*H10041246~
DMG*D8*19440826*M~
DTP*291*RD8*20251030-20260128~
EQ*42~
EQ*30~
SE*14*000000827~
GE*1*827~
IEA*1*000000827~

