ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260515*1305*^*00501*000045958*0*P*>~
GS*HS*52095*52095*260515*1305*1487113239*X*005010X279A1~
ST*270*000045958*005010X279A1~
BHT*0022*13*000045958*2605135*1305~
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*BAYNE*LARRY****MI*88322049~
DMG*D8*19681202*M~
DTP*291*RD8*20260515-20260813~
EQ*42~
EQ*30~
SE*14*000045958~
GE*1*45958~
IEA*1*000045958~