ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *251223*1212*^*00501*000037759*0*P*>~
GS*HS*52095*52095*251223*1212*1487113239*X*005010X279A1~
ST*270*000037759*005010X279A1~
BHT*0022*13*000037759*2512357*1212~
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*JONES*SYLVIA****MI*311050292~
DMG*D8*19491206*M~
DTP*291*RD8*20251223-20260323~
EQ*42~
EQ*30~
SE*14*000037759~
GE*1*37759~
IEA*1*000037759~