ISA*00*          *00*          *27*PPPPP          *27*SSSSSS         *091006*1250*`*00501*000000001*1*P*>~
GS*HP*SSSSSS*PPPPP*20091006*1250*1234*X*005010X221~
ST*835*000000001~
BPR*I*950*C*CHK************20091031~
TRN*1*10001*EEEEEEEEEE~
N1*PR*TEST 5010 PART B~
N3*456 MAIN STREET~
N4*BALTIMORE*MD*ZIPCDFOUR~
PER*BL*CLAIMS DEPARTMENT*TE*8005597282*EX*222~
N1*PE*MASTERS CLINIC*XX*NNNNNNNNNN~
N4*DALLAS*TX*ZIPCDFOUR~
REF*TJ*EEEEEEEEE~
LX*1~
CLP*1234-1*1*950*950**MB*AHL5-45~
NM1*QC*1*PUBLIC*JOHN*Q***MI*111111111F~
DTM*232*20090828~
DTM*050*20091006~
SE*16*000000001~
GE*1*1234~
IEA*1*000000001~
