ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260104*1401*^*00501*000038129*0*P*>~
GS*HS*52095*52095*260104*1401*1487113239*X*005010X279A1~
ST*270*000038129*005010X279A1~
BHT*0022*13*000038129*260104*1401~
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*ALMEIDA*EDWARD****MI*67308955~
DMG*D8*19500319*M~
DTP*291*RD8*20260104-20260404~
EQ*42~
EQ*30~
SE*14*000038129~
GE*1*38129~
IEA*1*000038129~

