ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260708*1607*^*00501*000047612*0*P*>~
GS*HS*52095*52095*260708*1607*1487113239*X*005010X279A1~
ST*270*000047612*005010X279A1~
BHT*0022*13*000047612*2607189*1607~
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*LAROCCA*CAROL****MI*841068524~
DMG*D8*19391119*F~
DTP*291*RD8*20260708-20261006~
EQ*42~
EQ*30~
SE*14*000047612~
GE*1*47612~
IEA*1*000047612~

