ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *251106*1311*^*00501*000032904*0*P*>~
GS*HS*52095*52095*251106*1311*1487113239*X*005010X279A1~
ST*270*000032904*005010X279A1~
BHT*0022*13*000032904*2511310*1311~
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*YEATON*EDWARD****MI*95280834~
DMG*D8*19471217*M~
DTP*291*RD8*20251106-20260204~
EQ*42~
EQ*30~
SE*14*000032904~
GE*1*32904~
IEA*1*000032904~