ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260129*1101*^*00501*000039436*0*P*>~
GS*HS*52095*52095*260129*1101*1487113239*X*005010X279A1~
ST*270*000039436*005010X279A1~
BHT*0022*13*000039436*260129*1101~
HL*1**20*1~
NM1*PR*2*KAISER MEDICAID*****PI*10403~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*WATKINS*CHARLESTON****MI*15184417~
DMG*D8*19401120*F~
DTP*291*RD8*20260129-20260429~
EQ*42~
EQ*30~
SE*14*000039436~
GE*1*39436~
IEA*1*000039436~