ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260221*1302*^*00501*000041371*0*P*>~
GS*HS*52095*52095*260221*1302*1487113239*X*005010X279A1~
ST*270*000041371*005010X279A1~
BHT*0022*13*000041371*260252*1302~
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*DUEY*DIANE****MI*82188542~
DMG*D8*19500114*F~
DTP*291*RD8*20260221-20260522~
EQ*42~
EQ*30~
SE*14*000041371~
GE*1*41371~
IEA*1*000041371~

