ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260408*1104*^*00501*000041747*0*P*>~
GS*HS*52095*52095*260408*1104*1487113239*X*005010X279A1~
ST*270*000041747*005010X279A1~
BHT*0022*13*000041747*260498*1104~
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*ELLIOTT*HELEN****MI*31218446~
DMG*D8*19830315*F~
DTP*291*RD8*20260408-20260707~
EQ*42~
EQ*30~
SE*14*000041747~
GE*1*41747~
IEA*1*000041747~