ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260409*1104*^*00501*000043895*0*P*>~
GS*HS*52095*52095*260409*1104*1487113239*X*005010X279A1~
ST*270*000043895*005010X279A1~
BHT*0022*13*000043895*260499*1104~
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*FAGAN*CHARLES****MI*34165599~
DMG*D8*19420903*M~
DTP*291*RD8*20260409-20260708~
EQ*42~
EQ*30~
SE*14*000043895~
GE*1*43895~
IEA*1*000043895~