ISA*00*          *00*          *ZZ*               *ZZ*               *260828*1108*^*00501*000002713*0*P*>~
GS*HS***260828*1108*1073904009*X*005010X279A1~
ST*270*000002713*005010X279A1~
BHT*0022*13*000002713*2608240*1108~
HL*1**20*1~
NM1*PR*2*ANTHEM HEALTHKEEPERS CCC PLUS*****PI*600112~
HL*2*1*21*1~
NM1*1P*2*GRACE HOME HEALTHCARE, LLC*****XX*1073904009~
HL*3*2*22*0~
NM1*IL*1*ABREHE*LETAY****MI*VAQ732202042~
DMG*D8*19420101*F~
DTP*291*RD8*20260828-20261126~
EQ*42~
EQ*30~
SE*14*000002713~
GE*1*2713~
IEA*1*000002713~

