ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *251230*1412*^*00501*000037914*0*P*>~
GS*HS*52095*52095*251230*1412*1487113239*X*005010X279A1~
ST*270*000037914*005010X279A1~
BHT*0022*13*000037914*2512364*1412~
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*DANIELS*GRACE****MI*88131162~
DMG*D8*19591223*F~
DTP*291*RD8*20251230-20260330~
EQ*42~
EQ*30~
SE*14*000037914~
GE*1*37914~
IEA*1*000037914~