ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260424*1704*^*00501*000044472*0*P*>~
GS*HS*52095*52095*260424*1704*1487113239*X*005010X279A1~
ST*270*000044472*005010X279A1~
BHT*0022*13*000044472*2604114*1704~
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*COX*EDWARD****MI*72266151~
DMG*D8*19540919*M~
DTP*291*RD8*20260424-20260723~
EQ*42~
EQ*30~
SE*14*000044472~
GE*1*44472~
IEA*1*000044472~