ISA*00*          *00*          *ZZ*BS15000504     *ZZ*15004          *260102*1001*^*00501*000000212*0*P*>~
GS*HS*15004*15004*260102*1001*1457998957*X*005010X279A1~
ST*270*000000212*005010X279A1~
BHT*0022*13*000000212*260102*1001~
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*TRUJILLO*EDDIE****MI*5FY6DM5WY47~
DMG*D8*19560727*M~
DTP*291*RD8*20260102-20260402~
EQ*42~
EQ*30~
SE*14*000000212~
GE*1*212~
IEA*1*000000212~