ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260702*1207*^*00501*000029423*0*P*>~
GS*HS*52095*52095*260702*1207*1487113239*X*005010X279A1~
ST*270*000029423*005010X279A1~
BHT*0022*13*000029423*2607183*1207~
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*ROBIER*EILEEN****MI*86107523~
DMG*D8*19430326*F~
DTP*291*RD8*20260702-20260930~
EQ*42~
EQ*30~
SE*14*000029423~
GE*1*29423~
IEA*1*000029423~