ISA*00*          *00*          *ZZ*BS15000504     *ZZ*15004          *260304*1603*^*00501*000047095*0*P*>~
GS*HS*15004*15004*260304*1603*1457998957*X*005010X279A1~
ST*270*000047095*005010X279A1~
BHT*0022*13*000047095*260363*1603~
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*HAMMONS*BRENDA****MI*9W51XP2RG10~
DMG*D8*19511201*F~
DTP*291*RD8*20260304-20260602~
EQ*42~
EQ*30~
SE*14*000047095~
GE*1*47095~
IEA*1*000047095~

