ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *250815*1508*^*00501*000030944*0*P*>~
GS*HS*52095*52095*250815*1508*1487113239*X*005010X279A1~
ST*270*000030944*005010X279A1~
BHT*0022*13*000030944*2508227*1508~
HL*1**20*1~
NM1*PR*2*KAISER PERMANENTE MEDICARE ADVANTAGE 1*****PI*10403~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*JOHNSON*TONY****MI*41312215~
DMG*D8*19560812*M~
DTP*291*RD8*20250815-20251113~
EQ*42~
EQ*30~
SE*14*000030944~
GE*1*30944~
IEA*1*000030944~