ISA*00*          *00*          *ZZ*000000         *ZZ*000000         *260304*1241*^*00501*000000014*0*P*>~
GS*HS*000000*000000*260304*1241*1043536642*X*005010X279A1~
ST*270*000000014*005010X279A1~
BHT*0022*13*000000014*260363*1241~
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*STELLA*JAMES****MI*1HA6QE8EW75~
DMG*D8*19410912*M~
DTP*291*RD8*20260304-20260602~
EQ*42~
EQ*30~
SE*14*000000014~
GE*1*14~
IEA*1*000000014~