ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *251202*1512*^*00501*000036548*0*P*>~
GS*HS*52095*52095*251202*1512*1487113239*X*005010X279A1~
ST*270*000036548*005010X279A1~
BHT*0022*13*000036548*2512336*1512~
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*SACCHETTI*MARY****MI*33168237~
DMG*D8*19460628*F~
DTP*291*RD8*20251202-20260302~
EQ*42~
EQ*30~
SE*14*000036548~
GE*1*36548~
IEA*1*000036548~