ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260604*1706*^*00501*000042884*0*P*>~
GS*HS*52095*52095*260604*1706*1487113239*X*005010X279A1~
ST*270*000042884*005010X279A1~
BHT*0022*13*000042884*2606155*1706~
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*MCCOY*LOUISE****MI*651091436~
DMG*D8*19430701*F~
DTP*291*RD8*20260604-20260902~
EQ*42~
EQ*30~
SE*14*000042884~
GE*1*42884~
IEA*1*000042884~