ISA*00*          *00*          *ZZ*1059619        *ZZ*263086998      *250731*1807*^*00501*000000085*0*P*>~
GS*HS*263086998*263086998*250731*1807*1356449631*X*005010X279A1~
ST*270*000000085*005010X279A1~
BHT*0022*13*000000085*2507212*1807~
HL*1**20*1~
NM1*PR*2*UNITED HEALTHCARE MEDICARE*****PI*877262~
HL*2*1*21*1~
NM1*1P*2*DELTA HEALTH HOME HEALTH*****XX*1356449631~
HL*3*2*22*0~
NM1*IL*1*HAMRICK*DONNA****MI*124006076~
DMG*D8*19560106*M~
DTP*291*RD8*20250731-20251029~
EQ*42~
EQ*30~
SE*14*000000085~
GE*1*85~
IEA*1*000000085~