ISA*00*          *00*          *ZZ*xxxxx          *ZZ*15004          *251103*1411*^*00501*000000847*0*P*>~
GS*HS*15004*15004*251103*1411*1073904009*X*005010X279A1~
ST*270*000000847*005010X279A1~
BHT*0022*13*000000847*2511307*1411~
HL*1**20*1~
NM1*PR*2*MEDICARE PPS*****PI*10000~
HL*2*1*21*1~
NM1*1P*2*GRACE HOME HEALTHCARE, LLC*****XX*1073904009~
HL*3*2*22*0~
NM1*IL*1*KNIGHT*ANN****MI*4C98VJ3JF32~
DMG*D8*19530227*F~
DTP*291*RD8*20251103-20260201~
EQ*42~
EQ*30~
SE*14*000000847~
GE*1*847~
IEA*1*000000847~