ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260508*1205*^*00501*000045667*0*P*>~
GS*HS*52095*52095*260508*1205*1487113239*X*005010X279A1~
ST*270*000045667*005010X279A1~
BHT*0022*13*000045667*2605128*1205~
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*AMOATIN*PHILIP****MI*83125291~
DMG*D8*19560205*M~
DTP*291*RD8*20260508-20260806~
EQ*42~
EQ*30~
SE*14*000045667~
GE*1*45667~
IEA*1*000045667~