ISA*00*          *00*          *ZZ*BS15000504     *ZZ*15004          *251104*1111*^*00501*000000201*0*P*>~
GS*HS*15004*15004*251104*1111*1457998957*X*005010X279A1~
ST*270*000000201*005010X279A1~
BHT*0022*13*000000201*2511308*1111~
HL*1**20*1~
NM1*PR*2*MEDICARE*****PI*06014~
HL*2*1*21*1~
NM1*1P*2*DEVOTION HOME HEALTH CARE, LLC*****XX*1457998957~
HL*3*2*22*0~
NM1*IL*1*YAZZIE*BIANCA****MI*8CH7GW5GF49~
DMG*D8*19551212*F~
DTP*291*RD8*20251104-20260202~
EQ*42~
EQ*30~
SE*14*000000201~
GE*1*201~
IEA*1*000000201~