ISA*00*          *00*          *ZZ*               *ZZ*               *260918*1509*^*00501*000002758*0*P*>~
GS*HS***260918*1509*1073904009*X*005010X279A1~
ST*270*000002758*005010X279A1~
BHT*0022*13*000002758*2609261*1509~
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*GLAZAMITSKY*YEFIM****MI*VAQ734136739~
DMG*D8*19380921*M~
DTP*291*RD8*20260918-20261217~
EQ*42~
EQ*30~
SE*14*000002758~
GE*1*2758~
IEA*1*000002758~

