ISA*00*          *00*          *ZZ*1457998957     *ZZ*87726          *251230*1712*^*00501*000000097*0*P*>~
GS*HS*87726*87726*251230*1712*1457998957*X*005010X279A1~
ST*270*000000097*005010X279A1~
BHT*0022*13*000000097*2512364*1712~
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*PESKIR*DOLORES****MI*982141781~
DMG*D8*19270606*F~
DTP*291*RD8*20251230-20260330~
EQ*42~
EQ*30~
SE*14*000000097~
GE*1*97~
IEA*1*000000097~