ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260627*1506*^*00501*000048098*0*P*>~
GS*HS*52095*52095*260627*1506*1487113239*X*005010X279A1~
ST*270*000048098*005010X279A1~
BHT*0022*13*000048098*2606178*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*FORREST*BENNIE****MI*16310143~
DMG*D8*19421208*M~
DTP*291*RD8*20260627-20260925~
EQ*42~
EQ*30~
SE*14*000048098~
GE*1*48098~
IEA*1*000048098~