ISA*00*          *00*          *ZZ*1059619        *ZZ*263086998      *250814*1708*^*00501*000000146*0*P*>~
GS*HS*263086998*263086998*250814*1708*1356449631*X*005010X279A1~
ST*270*000000146*005010X279A1~
BHT*0022*13*000000146*2508226*1708~
HL*1**20*1~
NM1*PR*2*MEDICARE*****PI*60000~
HL*2*1*21*1~
NM1*1P*2*DELTA HEALTH HOME HEALTH*****XX*1356449631~
HL*3*2*22*0~
NM1*IL*1*FAX*TEST****MI*5A97T15GD69~
DMG*D8*19600814*M~
DTP*291*RD8*20250814-20251112~
EQ*42~
EQ*30~
SE*14*000000146~
GE*1*146~
IEA*1*000000146~