ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *251219*0812*^*00501*000001275*0*P*>~
GS*HS*52095*52095*251219*0812*1073904009*X*005010X279A1~
ST*270*000001275*005010X279A1~
BHT*0022*13*000001275*2512353*0812~
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*HILL*DONNIE****MI*999048532~
DMG*D8*19351030*F~
DTP*291*RD8*20251219-20260319~
EQ*42~
EQ*30~
SE*14*000001275~
GE*1*1275~
IEA*1*000001275~