ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *251013*0710*^*00501*000033981*0*P*>~
GS*HS*52095*52095*251013*0710*1487113239*X*005010X279A1~
ST*270*000033981*005010X279A1~
BHT*0022*13*000033981*2510286*0710~
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*GILMORE*PATRICIA****MI*18177466~
DMG*D8*19540630*F~
DTP*291*RD8*20251013-20260111~
EQ*42~
EQ*30~
SE*14*000033981~
GE*1*33981~
IEA*1*000033981~