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GS>FA>SENDER>RECEIVER>20100624>1430>000000001>X>005010X214
ST>277>0001>005010X214
BHT>0085>08>277X2140001>20100624>1430>TH
HL>1>>20>1
NM1>AY>2>FIRST CLEARINGHOUSE>>>>>46>CLHR00
TRN>1>200102051635S00001ABCDEF
DTP>050>D8>20100623
DTP>009>D8>20100623
HL>2>1>21>1
NM1>41>2>BEST BILLING SERVICE>>>>>46>S00001
TRN>2>2002020542857
STC>A7:23>20100624>U>1000
QTY>AA>3
AMT>YY>1000.00
HL>3>2>19>0
NM1>85>2>SMITH CLINIC>>>>>XX>123456789
TRN>1>SMITH789
STC>A7:511:85>>U>1000.00>>>>>A7:504
QTY>QC>3
AMT>YY>1000.00
SE>20>0001
GE>1>000000001
IEA>1>000000001
