ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260203*1102*^*00501*000028829*0*P*>~
GS*HS*52095*52095*260203*1102*1487113239*X*005010X279A1~
ST*270*000028829*005010X279A1~
BHT*0022*13*000028829*260234*1102~
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*COVER*JANET****MI*44180353~
DMG*D8*19480501*F~
DTP*291*RD8*20260203-20260504~
EQ*42~
EQ*30~
SE*14*000028829~
GE*1*28829~
IEA*1*000028829~