ISA*00*          *00*          *ZZ*BS15000504     *ZZ*15004          *250724*1207*^*00501*000000033*0*P*>~
GS*HS*15004*15004*250724*1207*1457998957*X*005010X279A1~
ST*270*000000033*005010X279A1~
BHT*0022*13*000000033*2507205*1207~
HL*1**20*1~
NM1*PR*2*MEDICARE*****PI*15004~
HL*2*1*21*1~
NM1*1P*2*DEVOTION HOME HEALTH CARE, LLC*****XX*1457998957~
HL*3*2*22*0~
NM1*IL*1*TESTPATIENTVVP*MARK****MI*5W46E57XN09~
DMG*D8*19400518*M~
DTP*291*RD8*20250724-20251022~
EQ*42~
EQ*30~
SE*14*000000033~
GE*1*33~
IEA*1*000000033~