ISA*00*          *00*          *ZZ*120964         *ZZ*100000         *110819*1156*U*00401*000000028*0*P*:~
GS*HS*120964*100000*20110819*1156*00028*X*004010X092A1~
ST*270*0001~
BHT*0022*13**20110819*1156~
HL*1**20*1~
NM1*PR*2*NYSDOH*****PI*77027~
HL*2*1*21*1~
NM1*1P*2******XX*1700979465~
HL*3*2*22*0~
NM1*IL*1*CHANDLER*TAMMY****MI*8097370306~
DMG*D8*19801117*F~
DTP*472*D8*20101102~
EQ*30~
HL*4*1*21*1~
NM1*1P*2******XX*1700979465~
HL*5*4*22*0~
TRN*1*272762855*1593382974~
NM1*IL*1*ANDERS*MICHELLE****MI*4181760271~
REF*SY*272762855~
DMG*D8*19790525*F~
DTP*472*D8*20101001~
EQ*30~
HL*6*1*21*1~
NM1*1P*2******XX*1700979465~
HL*7*6*22*0~
TRN*1*267909128*1593382974~
NM1*IL*1*BONNER*WILLIE****MI*1429600284~
REF*SY*267909128~
DMG*D8*19491118*M~
DTP*472*D8*20101011~
EQ*30~
SE*30*0001~
GE*1*00028~
IEA*1*000000028~
