ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260213*1002*^*00501*000040958*0*P*>~
GS*HS*52095*52095*260213*1002*1487113239*X*005010X279A1~
ST*270*000040958*005010X279A1~
BHT*0022*13*000040958*260244*1002~
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*FAISON*LORETTA****MI*14304187~
DMG*D8*19470623*F~
DTP*291*RD8*20260213-20260514~
EQ*42~
EQ*30~
SE*14*000040958~
GE*1*40958~
IEA*1*000040958~