ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *250908*1209*^*00501*000030817*0*P*>~
GS*HS*52095*52095*250908*1209*1487113239*X*005010X279A1~
ST*270*000030817*005010X279A1~
BHT*0022*13*000030817*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*DELANEY*ROSIE****MI*02070173~
DMG*D8*19541212*F~
DTP*291*RD8*20250908-20251207~
EQ*42~
EQ*30~
SE*14*000030817~
GE*1*30817~
IEA*1*000030817~