ISA*00*          *00*          *ZZ*824026167      *ZZ*ABILITY837     *260730*1418*^*00501*000000187*0*P*>~
GS*HS*ABILITY837*ABILITY837*260730*1418*1184225021*X*005010X279A1~
ST*270*000000187*005010X279A1~
BHT*0022*13*000000187*2607211*1418~
HL*1**20*1~
NM1*PR*2*BCBS TANGO MA*****PI*26748~
HL*2*1*21*1~
NM1*1P*2*EVERGREEN HOME HEALTH*****XX*1184225021~
HL*3*2*22*0~
NM1*IL*1*MOORE*KATHLEEN****MI*X3LM62093889~
DMG*D8*19530127*F~
DTP*291*RD8*20260730-20261028~
EQ*42~
EQ*30~
SE*14*000000187~
GE*1*187~
IEA*1*000000187~