ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260629*1206*^*00501*000048099*0*P*>~
GS*HS*52095*52095*260629*1206*1487113239*X*005010X279A1~
ST*270*000048099*005010X279A1~
BHT*0022*13*000048099*2606180*1206~
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*COLLINS*ANNIE****MI*12263574~
DMG*D8*19420609*F~
DTP*291*RD8*20260629-20260927~
EQ*42~
EQ*30~
SE*14*000048099~
GE*1*48099~
IEA*1*000048099~