ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *251130*1411*^*00501*000036447*0*P*>~
GS*HS*52095*52095*251130*1411*1487113239*X*005010X279A1~
ST*270*000036447*005010X279A1~
BHT*0022*13*000036447*2511334*1411~
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*BRAILSFORD*LINDA****MI*89329369~
DMG*D8*19570407*F~
DTP*291*RD8*20251130-20260228~
EQ*42~
EQ*30~
SE*14*000036447~
GE*1*36447~
IEA*1*000036447~