ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260502*1505*^*00501*000002199*0*P*>~
GS*HS*52095*52095*260502*1505*1073904009*X*005010X279A1~
ST*270*000002199*005010X279A1~
BHT*0022*13*000002199*2605122*1505~
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*FRANCIS*JOSEPH****MI*01086048~
DMG*D8*19360601*M~
DTP*291*RD8*20260502-20260731~
EQ*42~
EQ*30~
SE*14*000002199~
GE*1*2199~
IEA*1*000002199~

