ISA*00*          *00*          *ZZ*xxxxx          *ZZ*52095          *260617*1006*^*00501*000002476*0*P*>~
GS*HS*52095*52095*260617*1006*1073904009*X*005010X279A1~
ST*270*000002476*005010X279A1~
BHT*0022*13*000002476*2606168*1006~
HL*1**20*1~
NM1*PR*2*KAISER PERMANENTE MEDICARE ADVANTAGE 1*****PI*10403~
HL*2*1*21*1~
NM1*1P*2*GRACE HOME HEALTHCARE, LLC*****XX*1073904009~
HL*3*2*22*0~
NM1*IL*1*PANOUSSI*JULIE****MI*131051891~
DMG*D8*19500415*F~
DTP*291*RD8*20260617-20260915~
EQ*42~
EQ*30~
SE*14*000002476~
GE*1*2476~
IEA*1*000002476~

