ISA*00*          *00*          *ZZ*1234           *ZZ*12345          *260609*1506*^*00501*000000044*0*P*>~
GS*HS*12345*12345*260609*1506*1356410088*X*005010X279A1~
ST*270*000000044*005010X279A1~
BHT*0022*13*000000044*2606160*1506~
HL*1**20*1~
NM1*PR*2*AETNA MEDICARE*****PI*34010~
HL*2*1*21*1~
NM1*1P*2*SPECIAL CARE HOSPICE & HOME HEALTH*****XX*1356410088~
HL*3*2*22*0~
NM1*IL*1*BROWN*LONNIE****MI*7RM9VG8VD49~
DMG*D8*19540105*M~
DTP*291*RD8*20260609-20260907~
EQ*42~
EQ*30~
SE*14*000000044~
GE*1*44~
IEA*1*000000044~