ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260709*0907*^*00501*000047241*0*P*>~
GS*HS*52095*52095*260709*0907*1487113239*X*005010X279A1~
ST*270*000047241*005010X279A1~
BHT*0022*13*000047241*2607190*0907~
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*LEWIS-BROOKS*EDITH****MI*36165256~
DMG*D8*19570317*M~
DTP*291*RD8*20260709-20261007~
EQ*42~
EQ*30~
SE*14*000047241~
GE*1*47241~
IEA*1*000047241~