ISA*00*          *00*          *ZZ*1457998957     *ZZ*3432           *260702*0907*^*00501*000047170*0*P*>~
GS*HS*3432*3432*260702*0907*1457998957*X*005010X279A1~
ST*270*000047170*005010X279A1~
BHT*0022*13*000047170*2607183*0907~
HL*1**20*1~
NM1*PR*2*UHC AHCCCS/ALTCS*****PI*03432~
HL*2*1*21*1~
NM1*1P*2*DEVOTION HOME HEALTH CARE, LLC*****XX*1457998957~
HL*3*2*22*0~
NM1*IL*1*BULLARD*DAWNYA SHANE****MI*A31100386~
DMG*D8*19800517*F~
DTP*291*RD8*20260702-20260930~
EQ*42~
EQ*30~
SE*14*000047170~
GE*1*47170~
IEA*1*000047170~

