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GS*HS*XXXXXXXX*XXXXXXXX*250828*1008*1457998957*X*005010X279A1~
ST*270*000000116*005010X279A1~
BHT*0022*13*000000116*2508240*1008~
HL*1**20*1~
NM1*PR*2*GILA RIVER HEALTH CARE*****PI*55413~
HL*2*1*21*1~
NM1*1P*2*DEVOTION HOME HEALTH CARE, LLC*****XX*1457998957~
HL*3*2*22*0~
NM1*IL*1*TEST*FAX****MI*5A97T15GD69~
DMG*D8*19600826*M~
DTP*291*RD8*20250828-20251126~
EQ*42~
EQ*30~
SE*14*000000116~
GE*1*116~
IEA*1*000000116~

