ISA*00*          *00*          *ZZ*xxxxx          *ZZ*15004          *260428*1404*^*00501*000002185*0*P*>~
GS*HS*15004*15004*260428*1404*1073904009*X*005010X279A1~
ST*270*000002185*005010X279A1~
BHT*0022*13*000002185*2604118*1404~
HL*1**20*1~
NM1*PR*2*MEDICARE PPS*****PI*10000~
HL*2*1*21*1~
NM1*1P*2*GRACE HOME HEALTHCARE, LLC*****XX*1073904009~
HL*3*2*22*0~
NM1*IL*1*BUSSEY*ELLEN****MI*1X10A95KA39~
DMG*D8*19421217*F~
DTP*291*RD8*20260428-20260727~
EQ*42~
EQ*30~
SE*14*000002185~
GE*1*2185~
IEA*1*000002185~