ISA*00*          *00*          *ZZ*xxxxx          *ZZ*15004          *260727*1607*^*00501*000002634*0*P*>~
GS*HS*15004*15004*260727*1607*1073904009*X*005010X279A1~
ST*270*000002634*005010X279A1~
BHT*0022*13*000002634*2607208*1607~
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*THOMAS*LOWELL****MI*4HM0FA2RK16~
DMG*D8*19320412*M~
DTP*291*RD8*20260727-20261025~
EQ*42~
EQ*30~
SE*14*000002634~
GE*1*2634~
IEA*1*000002634~

