ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260106*1601*^*00501*000038639*0*P*>~
GS*HS*52095*52095*260106*1601*1487113239*X*005010X279A1~
ST*270*000038639*005010X279A1~
BHT*0022*13*000038639*260106*1601~
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*PULLEY*RUSSELL****MI*78272187~
DMG*D8*19540202*M~
DTP*291*RD8*20260106-20260406~
EQ*42~
EQ*30~
SE*14*000038639~
GE*1*38639~
IEA*1*000038639~