ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260423*1004*^*00501*000044393*0*P*>~
GS*HS*52095*52095*260423*1004*1487113239*X*005010X279A1~
ST*270*000044393*005010X279A1~
BHT*0022*13*000044393*2604113*1004~
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*WILSON*DIANA****MI*61139001~
DMG*D8*19421027*F~
DTP*291*RD8*20260423-20260722~
EQ*42~
EQ*30~
SE*14*000044393~
GE*1*44393~
IEA*1*000044393~