ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260604*1606*^*00501*000042952*0*P*>~
GS*HS*52095*52095*260604*1606*1487113239*X*005010X279A1~
ST*270*000042952*005010X279A1~
BHT*0022*13*000042952*2606155*1606~
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*KATSIKADAKOS*DIMITRIS****MI*94207215~
DMG*D8*19811227*M~
DTP*291*RD8*20260604-20260902~
EQ*42~
EQ*30~
SE*14*000042952~
GE*1*42952~
IEA*1*000042952~