ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260701*1507*^*00501*000048169*0*P*>~
GS*HS*52095*52095*260701*1507*1487113239*X*005010X279A1~
ST*270*000048169*005010X279A1~
BHT*0022*13*000048169*2607182*1507~
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*MCCLAIN*MARY****MI*83143192~
DMG*D8*19480907*F~
DTP*291*RD8*20260701-20260929~
EQ*42~
EQ*30~
SE*14*000048169~
GE*1*48169~
IEA*1*000048169~