ISA*00*          *00*          *ZZ*824026167      *ZZ*ABILITY837     *260731*0851*^*00501*000000189*0*P*>~
GS*HS*ABILITY837*ABILITY837*260731*0851*1184225021*X*005010X279A1~
ST*270*000000189*005010X279A1~
BHT*0022*13*000000189*2607212*0851~
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*KRENZ*MARY****MI*x3Im68330453~
DMG*D8*19330616*F~
DTP*291*RD8*20260731-20261029~
EQ*42~
EQ*30~
SE*14*000000189~
GE*1*189~
IEA*1*000000189~