ISA*00*          *00*          *ZZ*xxxxx          *ZZ*52095          *251201*1012*^*00501*000001054*0*P*>~
GS*HS*52095*52095*251201*1012*1073904009*X*005010X279A1~
ST*270*000001054*005010X279A1~
BHT*0022*13*000001054*2512335*1012~
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*MURPHY*JOHN****MI*01194108~
DMG*D8*19420503*F~
DTP*291*RD8*20251201-20260301~
EQ*42~
EQ*30~
SE*14*000001054~
GE*1*1054~
IEA*1*000001054~