ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260413*1404*^*00501*000029997*0*P*>~
GS*HS*52095*52095*260413*1404*1487113239*X*005010X279A1~
ST*270*000029997*005010X279A1~
BHT*0022*13*000029997*2604103*1404~
HL*1**20*1~
NM1*PR*2*KAISER PERMANENTE*****PI*10403~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*WIGGINS*GWENDOLYN****MI*78283121~
DMG*D8*19560318*F~
DTP*291*RD8*20260413-20260712~
EQ*42~
EQ*30~
SE*14*000029997~
GE*1*29997~
IEA*1*000029997~