ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *251121*0911*^*00501*000034946*0*P*>~
GS*HS*52095*52095*251121*0911*1487113239*X*005010X279A1~
ST*270*000034946*005010X279A1~
BHT*0022*13*000034946*2511325*0911~
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*FRETWELL*CHARLES****MI*18174745~
DMG*D8*19490610*M~
DTP*291*RD8*20251121-20260219~
EQ*42~
EQ*30~
SE*14*000034946~
GE*1*34946~
IEA*1*000034946~