ISA*00*          *00*          *ZZ*10353          *ZZ*10353          *251215*1512*^*00501*000001232*0*P*>~
GS*HS*10353*10353*251215*1512*1073904009*X*005010X279A1~
ST*270*000001232*005010X279A1~
BHT*0022*13*000001232*2512349*1512~
HL*1**20*1~
NM1*PR*2*HUMANA GOLD CHOICE*****PI*6013~
HL*2*1*21*1~
NM1*1P*2*GRACE HOME HEALTHCARE, LLC*****XX*1073904009~
HL*3*2*22*0~
NM1*IL*1*VESEY*JOHN****MI*H65244536~
DMG*D8*19470822*M~
DTP*291*RD8*20251215-20260315~
EQ*42~
EQ*30~
SE*14*000001232~
GE*1*1232~
IEA*1*000001232~

