ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *251028*1610*^*00501*000034661*0*P*>~
GS*HS*52095*52095*251028*1610*1487113239*X*005010X279A1~
ST*270*000034661*005010X279A1~
BHT*0022*13*000034661*2510301*1610~
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*DAY*NORMAN****MI*61247265~
DMG*D8*19440211*M~
DTP*291*RD8*20251028-20260126~
EQ*42~
EQ*30~
SE*14*000034661~
GE*1*34661~
IEA*1*000034661~