ISA*00*          *00*          *ZZ*12345          *ZZ*12345          *251106*1011*^*00501*000005607*0*P*>~
GS*HS*12345*12345*251106*1011*1234567891*X*005010X279A1~
ST*270*000005607*005010X279A1~
BHT*0022*13*000005607*2511310*1011~
HL*1**20*1~
NM1*PR*2*MEDICARE ARIZONA*****PI*00832~
HL*2*1*21*1~
NM1*1P*2*HOME HEALTH CARES*****XX*1234567891~
HL*3*2*22*0~
NM1*IL*1*HART*KYLE****MI*5W46E57XN06~
DMG*D8*20250914*M~
DTP*291*RD8*20251106-20260204~
EQ*42~
EQ*30~
SE*14*000005607~
GE*1*5607~
IEA*1*000005607~