ISA*00*          *00*          *ZZ*1457998957     *ZZ*87726          *250825*1208*^*00501*000000107*0*P*>~
GS*HS*87726*87726*250825*1208*1457998957*X*005010X279A1~
ST*270*000000107*005010X279A1~
BHT*0022*13*000000107*2508237*1208~
HL*1**20*1~
NM1*PR*2*UHC MEDICARE ADVANTAGE*****PI*87726~
HL*2*1*21*1~
NM1*1P*2*DEVOTION HOME HEALTH CARE, LLC*****XX*1457998957~
HL*3*2*22*0~
NM1*IL*1*RIVERA*RAYMOND****MI*115656673~
DMG*D8*19510303*M~
DTP*291*RD8*20250825-20251123~
EQ*42~
EQ*30~
SE*14*000000107~
GE*1*107~
IEA*1*000000107~