ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *250911*0909*^*00501*000032329*0*P*>~
GS*HS*52095*52095*250911*0909*1487113239*X*005010X279A1~
ST*270*000032329*005010X279A1~
BHT*0022*13*000032329*2509254*0909~
HL*1**20*1~
NM1*PR*2*KAISER MEDICAID*****PI*10403~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*MILES*BRIAN****MI*92353703~
DMG*D8*19811016*M~
DTP*291*RD8*20250911-20251210~
EQ*42~
EQ*30~
SE*14*000032329~
GE*1*32329~
IEA*1*000032329~