ISA*00*          *00*          *ZZ*000000         *ZZ*000000         *260313*1403*^*00501*000000059*0*P*>~
GS*HS*000000*000000*260313*1403*1043536642*X*005010X279A1~
ST*270*000000059*005010X279A1~
BHT*0022*13*000000059*260372*1403~
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*RIVKIN*WILLIAM****MI*3H46Y79NY82~
DMG*D8*19371024*M~
DTP*291*RD8*20260313-20260611~
EQ*42~
EQ*30~
SE*14*000000059~
GE*1*59~
IEA*1*000000059~