ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260114*1701*^*00501*000038999*0*P*>~
GS*HS*52095*52095*260114*1701*1487113239*X*005010X279A1~
ST*270*000038999*005010X279A1~
BHT*0022*13*000038999*260114*1701~
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*KOEPPER*FREDERICK****MI*98282298~
DMG*D8*19470526*M~
DTP*291*RD8*20260114-20260414~
EQ*42~
EQ*30~
SE*14*000038999~
GE*1*38999~
IEA*1*000038999~