ISA*00*          *00*          *ZZ*824026167      *ZZ*ABILITY837     *260804*0831*^*00501*000000230*0*P*>~
GS*HS*ABILITY837*ABILITY837*260804*0831*1184225021*X*005010X279A1~
ST*270*000000230*005010X279A1~
BHT*0022*13*000000230*2608216*0831~
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*STEWART*ROBERT****MI*X3LM60510151~
DMG*D8*19531103*M~
DTP*291*RD8*20260804-20261102~
EQ*42~
EQ*30~
SE*14*000000230~
GE*1*230~
IEA*1*000000230~