ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *250818*0808*^*00501*000030982*0*P*>~
GS*HS*52095*52095*250818*0808*1487113239*X*005010X279A1~
ST*270*000030982*005010X279A1~
BHT*0022*13*000030982*2508230*0808~
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*STULLER*MARY****MI*131282918~
DMG*D8*19470413*F~
DTP*291*RD8*20250818-20251116~
EQ*42~
EQ*30~
SE*14*000030982~
GE*1*30982~
IEA*1*000030982~