ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260220*0902*^*00501*000041328*0*P*>~
GS*HS*52095*52095*260220*0902*1487113239*X*005010X279A1~
ST*270*000041328*005010X279A1~
BHT*0022*13*000041328*260251*0902~
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*SAVAGE*KIM****MI*99202689~
DMG*D8*19670611*F~
DTP*291*RD8*20260220-20260521~
EQ*42~
EQ*30~
SE*14*000041328~
GE*1*41328~
IEA*1*000041328~