ISA*00*          *00*          *ZZ*1059619        *ZZ*263086998      *250819*1708*^*00501*000000147*0*P*>~
GS*HS*263086998*263086998*250819*1708*1356449631*X*005010X279A1~
ST*270*000000147*005010X279A1~
BHT*0022*13*000000147*2508231*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*TESTING*FAX****MI*7GJ1QE6JE38~
DMG*D8*19591213*M~
DTP*291*RD8*20250819-20251117~
EQ*42~
EQ*30~
SE*14*000000147~
GE*1*147~
IEA*1*000000147~