ISA*00*          *00*          *ZZ*               *ZZ*               *260303*1147*^*00501*000000004*0*P*>~
GS*HS***260303*1147*1043536642*X*005010X279A1~
ST*270*000000004*005010X279A1~
BHT*0022*13*000000004*260362*1147~
HL*1**20*1~
NM1*PR*2*MEDICARE*****PI*12345~
HL*2*1*21*1~
NM1*1P*2*MEDI LINK HEALTH SERVICES LLC*****XX*1043536642~
HL*3*2*22*0~
NM1*IL*1*ROVEL*JEROME****MI*7UV6P52NQ76~
DMG*D8*19490417*M~
DTP*291*RD8*20260303-20260601~
EQ*42~
EQ*30~
SE*14*000000004~
GE*1*4~
IEA*1*000000004~