ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260616*1406*^*00501*000047760*0*P*>~
GS*HS*52095*52095*260616*1406*1487113239*X*005010X279A1~
ST*270*000047760*005010X279A1~
BHT*0022*13*000047760*2606167*1406~
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*RODGERS*DESTINY****MI*66264934~
DMG*D8*19951129*F~
DTP*291*RD8*20260616-20260914~
EQ*42~
EQ*30~
SE*14*000047760~
GE*1*47760~
IEA*1*000047760~