ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260504*1005*^*00501*000044767*0*P*>~
GS*HS*52095*52095*260504*1005*1487113239*X*005010X279A1~
ST*270*000044767*005010X279A1~
BHT*0022*13*000044767*2605124*1005~
HL*1**20*1~
NM1*PR*2*KAISER PERMANENTE MEDICAID JOINT*****PI*10403~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*STACKHOUSE*GREOGRY****MI*27276599~
DMG*D8*19850625*M~
DTP*291*RD8*20260504-20260802~
EQ*42~
EQ*30~
SE*14*000044767~
GE*1*44767~
IEA*1*000044767~