ISA*00*          *00*          *ZZ*               *ZZ*               *251210*1212*^*00501*000001122*0*P*>~
GS*HS***251210*1212*1073904009*X*005010X279A1~
ST*270*000001122*005010X279A1~
BHT*0022*13*000001122*2512344*1212~
HL*1**20*1~
NM1*PR*2*ANTHEM HEALTHKEEPERS CCC PLUS*****PI*600112~
HL*2*1*21*1~
NM1*1P*2*GRACE HOME HEALTHCARE, LLC*****XX*1073904009~
HL*3*2*22*0~
NM1*IL*1*TAO*PING****MI*VAQ737691430~
DMG*D8*19430316*F~
DTP*291*RD8*20251210-20260310~
EQ*42~
EQ*30~
SE*14*000001122~
GE*1*1122~
IEA*1*000001122~