ISA*00*          *00*          *ZZ*10353          *ZZ*10353          *260814*1108*^*00501*000002681*0*P*>~
GS*HS*10353*10353*260814*1108*1073904009*X*005010X279A1~
ST*270*000002681*005010X279A1~
BHT*0022*13*000002681*2608226*1108~
HL*1**20*1~
NM1*PR*2*HUMANA GOLD CHOICE*****PI*6013~
HL*2*1*21*1~
NM1*1P*2*GRACE HOME HEALTHCARE, LLC*****XX*1073904009~
HL*3*2*22*0~
NM1*IL*1*EBRAHIMI*ABBAS****MI*H94530055~
DMG*D8*19610121*M~
DTP*291*RD8*20260814-20261112~
EQ*42~
EQ*30~
SE*14*000002681~
GE*1*2681~
IEA*1*000002681~

