ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *251209*1012*^*00501*000037191*0*P*>~
GS*HS*52095*52095*251209*1012*1487113239*X*005010X279A1~
ST*270*000037191*005010X279A1~
BHT*0022*13*000037191*2512343*1012~
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*DEEMER*BONNIE****MI*94197121~
DMG*D8*19510104*F~
DTP*291*RD8*20251209-20260309~
EQ*42~
EQ*30~
SE*14*000037191~
GE*1*37191~
IEA*1*000037191~