ISA*00*          *00*          *ZZ*1059619        *ZZ*263086998      *250801*1808*^*00501*000000096*0*P*>~
GS*HS*263086998*263086998*250801*1808*1356449631*X*005010X279A1~
ST*270*000000096*005010X279A1~
BHT*0022*13*000000096*2508213*1808~
HL*1**20*1~
NM1*PR*2*TANGO HUMANA*****PI*26748~
HL*2*1*21*1~
NM1*1P*2*DELTA HEALTH HOME HEALTH*****XX*1356449631~
HL*3*2*22*0~
NM1*IL*1*BRUEGGEMANN*THEODORE****MI*H72935426~
DMG*D8*19420514*M~
DTP*291*RD8*20250801-20251030~
EQ*42~
EQ*30~
SE*14*000000096~
GE*1*96~
IEA*1*000000096~