ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *250902*0809*^*00501*000031487*0*P*>~
GS*HS*52095*52095*250902*0809*1487113239*X*005010X279A1~
ST*270*000031487*005010X279A1~
BHT*0022*13*000031487*2509245*0809~
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*HOLLIDGE*MARGARET****MI*97217360~
DMG*D8*19451102*F~
DTP*291*RD8*20250902-20251201~
EQ*42~
EQ*30~
SE*14*000031487~
GE*1*31487~
IEA*1*000031487~