ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *251023*1010*^*00501*000034449*0*P*>~
GS*HS*52095*52095*251023*1010*1487113239*X*005010X279A1~
ST*270*000034449*005010X279A1~
BHT*0022*13*000034449*2510296*1010~
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*CARICO*MARY****MI*661132353~
DMG*D8*19381221*F~
DTP*291*RD8*20251023-20260121~
EQ*42~
EQ*30~
SE*14*000034449~
GE*1*34449~
IEA*1*000034449~