ISA*00*          *00*          *ZZ*824026167      *ZZ*ABILITY837     *260803*0936*^*00501*000000223*0*P*>~
GS*HS*ABILITY837*ABILITY837*260803*0936*1184225021*X*005010X279A1~
ST*270*000000223*005010X279A1~
BHT*0022*13*000000223*2608215*0936~
HL*1**20*1~
NM1*PR*2*OPTUM VA CCN REGION 2*****PI*VACCN~
HL*2*1*21*1~
NM1*1P*2*EVERGREEN HOME HEALTH*****XX*1184225021~
HL*3*2*22*0~
NM1*IL*1*RIVARD*DAVID****MI*1009823379V911581~
DMG*D8*19570522*M~
DTP*291*RD8*20260803-20261101~
EQ*42~
EQ*30~
SE*14*000000223~
GE*1*223~
IEA*1*000000223~