ISA*00*          *00*          *ZZ*xxxxxx         *ZZ*SKMD0          *260423*1504*^*00501*000002171*0*P*>~
GS*HS*SKMD0*SKMD0*260423*1504*1073904009*X*005010X279A1~
ST*270*000002171*005010X279A1~
BHT*0022*13*000002171*2604113*1504~
HL*1**20*1~
NM1*PR*2*MARYLAND MEDICAID*****PI*SKMD0~
HL*2*1*21*1~
NM1*1P*2*GRACE HOME HEALTHCARE, LLC*****XX*1073904009~
HL*3*2*22*0~
NM1*IL*1*COSBY*BRANDEN****MI*49001564800~
DMG*D8*19910219*M~
DTP*291*RD8*20260423-20260722~
EQ*42~
EQ*30~
SE*14*000002171~
GE*1*2171~
IEA*1*000002171~