ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *251204*1512*^*00501*000001077*0*P*>~
GS*HS*52095*52095*251204*1512*1073904009*X*005010X279A1~
ST*270*000001077*005010X279A1~
BHT*0022*13*000001077*2512338*1512~
HL*1**20*1~
NM1*PR*2*KAISER PERMANENTE*****PI*10403~
HL*2*1*21*1~
NM1*1P*2*GRACE HOME HEALTHCARE, LLC*****XX*1073904009~
HL*3*2*22*0~
NM1*IL*1*HEMLEY*JOHN****MI*01243026~
DMG*D8*19261108*M~
DTP*291*RD8*20251204-20260304~
EQ*42~
EQ*30~
SE*14*000001077~
GE*1*1077~
IEA*1*000001077~