ISA*00*          *00*          *ZZ*10353          *ZZ*10353          *260107*1301*^*00501*000001111*0*P*>~
GS*HS*10353*10353*260107*1301*1073904009*X*005010X279A1~
ST*270*000001111*005010X279A1~
BHT*0022*13*000001111*260107*1301~
HL*1**20*1~
NM1*PR*2*HUMANA CHOICECARE*****PI*600083~
HL*2*1*21*1~
NM1*1P*2*GRACE HOME HEALTHCARE, LLC*****XX*1073904009~
HL*3*2*22*0~
NM1*IL*1*RIOS*MARIO****MI*H60935669~
DMG*D8*19530225*M~
DTP*291*RD8*20260107-20260407~
EQ*42~
EQ*30~
SE*14*000001111~
GE*1*1111~
IEA*1*000001111~