ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260623*1006*^*00501*000047935*0*P*>~
GS*HS*52095*52095*260623*1006*1487113239*X*005010X279A1~
ST*270*000047935*005010X279A1~
BHT*0022*13*000047935*2606174*1006~
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*JOHNSON*JOANNA****MI*01242573~
DMG*D8*19511019*F~
DTP*291*RD8*20260623-20260921~
EQ*42~
EQ*30~
SE*14*000047935~
GE*1*47935~
IEA*1*000047935~