ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260523*1305*^*00501*000046259*0*P*>~
GS*HS*52095*52095*260523*1305*1487113239*X*005010X279A1~
ST*270*000046259*005010X279A1~
BHT*0022*13*000046259*2605143*1305~
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*OGIN*RICHARD****MI*931057785~
DMG*D8*20260523*M~
DTP*291*RD8*20260523-20260821~
EQ*42~
EQ*30~
SE*14*000046259~
GE*1*46259~
IEA*1*000046259~

