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GS*HS*SKAZ0*SKAZ0*250724*1307*1457998957*X*005010X279A1~
ST*270*000000037*005010X279A1~
BHT*0022*13*000000037*2507205*1307~
HL*1**20*1~
NM1*PR*2*AHCCCS*****PI*SKAZ0~
HL*2*1*21*1~
NM1*1P*2*DEVOTION HOME HEALTH CARE, LLC*****XX*1457998957~
HL*3*2*22*0~
NM1*IL*1*TEST*FOUR****MI*A56789323~
DMG*D8*19611214*M~
DTP*291*RD8*20250724-20251022~
EQ*42~
EQ*30~
SE*14*000000037~
GE*1*37~
IEA*1*000000037~