ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *251124*0711*^*00501*000036259*0*P*>~
GS*HS*52095*52095*251124*0711*1487113239*X*005010X279A1~
ST*270*000036259*005010X279A1~
BHT*0022*13*000036259*2511328*0711~
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*DAMBROSIO*MICHAEL****MI*19314892~
DMG*D8*19590815*M~
DTP*291*RD8*20251124-20260222~
EQ*42~
EQ*30~
SE*14*000036259~
GE*1*36259~
IEA*1*000036259~