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GS*HI*ZZ000*ZZ001*20030828*1128*17*X*004010X094A1~
ST*278*11280001~
BHT*0078*11*121231*20050802*1202~
SE*3*11280001~
ST*278*11280002~
BHT*0078*13*121231*20050802*1202~
SE*3*11280002~
ST*278*11280003~
BHT*0078*11*121231*20050802*1202~
SE*3*11280003~
GE*3*17~
GS*HC*ZZ000*ZZ001*20030828*1128*18*X*004010X098A1~
ST*837*11280001~
BHT*0019*00*121231*20050802*1202*CH~
SE*3*11280001~
GE*1*18~
GS*HP*D00111*00GR*20041028*1609*383880001*X*004010X091A1~
ST*835*0001~
SE*2*0001~
GE*1*383880001~
IEA*3*000010121~