ISA*00*          *00*          *ZZ*BS15000504     *ZZ*15004          *260102*0901*^*00501*000000239*0*P*>~
GS*HS*15004*15004*260102*0901*1457998957*X*005010X279A1~
ST*270*000000239*005010X279A1~
BHT*0022*13*000000239*260102*0901~
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*PESKIR*DOLORES****MI*9W44YE1RM82~
DMG*D8*19270606*F~
DTP*291*RD8*20260102-20260402~
EQ*42~
EQ*30~
SE*14*000000239~
GE*1*239~
IEA*1*000000239~