ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *250908*1209*^*00501*000004349*0*P*>~
GS*HS*52095*52095*250908*1209*1487113239*X*005010X279A1~
ST*270*000004349*005010X279A1~
BHT*0022*13*000004349*2509251*1209~
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*FORSHA*DENIS****MI*291040720~
DMG*D8*19560119*M~
DTP*291*RD8*20250908-20251207~
EQ*42~
EQ*30~
SE*14*000004349~
GE*1*4349~
IEA*1*000004349~