ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *250821*1308*^*00501*000031184*0*P*>~
GS*HS*52095*52095*250821*1308*1487113239*X*005010X279A1~
ST*270*000031184*005010X279A1~
BHT*0022*13*000031184*2508233*1308~
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*WILLIAMS*EULA****MI*16338001~
DMG*D8*19590808*F~
DTP*291*RD8*20250821-20251119~
EQ*42~
EQ*30~
SE*14*000031184~
GE*1*31184~
IEA*1*000031184~