ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260605*1506*^*00501*000047255*0*P*>~
GS*HS*52095*52095*260605*1506*1487113239*X*005010X279A1~
ST*270*000047255*005010X279A1~
BHT*0022*13*000047255*2606156*1506~
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*WELLS*DELBERT****MI*471024188~
DMG*D8*19430507*M~
DTP*291*RD8*20260605-20260903~
EQ*42~
EQ*30~
SE*14*000047255~
GE*1*47255~
IEA*1*000047255~