ISA*00*          *00*          *ZZ*000000         *ZZ*000000         *260312*1857*^*00501*000000053*0*P*>~
GS*HS*000000*000000*260312*1857*1043536642*X*005010X279A1~
ST*270*000000053*005010X279A1~
BHT*0022*13*000000053*260371*1857~
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*FAVIA*JOHN****MI*8XE7Y56RQ54~
DMG*D8*19471218*M~
DTP*291*RD8*20260312-20260610~
EQ*42~
EQ*30~
SE*14*000000053~
GE*1*53~
IEA*1*000000053~

