ISA*00*          *00*          *ZZ*000000         *ZZ*000000         *260316*1703*^*00501*000000081*0*P*>~
GS*HS*000000*000000*260316*1703*1043536642*X*005010X279A1~
ST*270*000000081*005010X279A1~
BHT*0022*13*000000081*260375*1703~
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*VALOIS*MARGARET****MI*5A28JP9MC32~
DMG*D8*19280709*F~
DTP*291*RD8*20260316-20260614~
EQ*42~
EQ*30~
SE*14*000000081~
GE*1*81~
IEA*1*000000081~