ISA*00*          *00*          *ZZ*xxxxx          *ZZ*52095          *251103*0911*^*00501*000000835*0*P*>~
GS*HS*52095*52095*251103*0911*1073904009*X*005010X279A1~
ST*270*000000835*005010X279A1~
BHT*0022*13*000000835*2511307*0911~
HL*1**20*1~
NM1*PR*2*KAISER PERMANENTE MEDICARE ADVANTAGE 1*****PI*10403~
HL*2*1*21*1~
NM1*1P*2*GRACE HOME HEALTHCARE, LLC*****XX*1073904009~
HL*3*2*22*0~
NM1*IL*1*MCDONALD*JULIA****MI*01112668~
DMG*D8*19361204*F~
DTP*291*RD8*20251103-20260201~
EQ*42~
EQ*30~
SE*14*000000835~
GE*1*835~
IEA*1*000000835~