ISA*00*          *00*          *ZZ*BS15000504     *ZZ*15004          *260605*0106*^*00501*000047412*0*P*>~
GS*HS*15004*15004*260605*0106*1457998957*X*005010X279A1~
ST*270*000047412*005010X279A1~
BHT*0022*13*000047412*2606156*0106~
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*BUTLER*CHARMELLE****MI*4A78VJ2TD67~
DMG*D8*19740114*F~
DTP*291*RD8*20260605-20260903~
EQ*42~
EQ*30~
SE*14*000047412~
GE*1*47412~
IEA*1*000047412~

