ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260713*1307*^*00501*000049059*0*P*>~
GS*HS*52095*52095*260713*1307*1487113239*X*005010X279A1~
ST*270*000049059*005010X279A1~
BHT*0022*13*000049059*2607194*1307~
HL*1**20*1~
NM1*PR*2*KAISER MEDICAID*****PI*10403~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*MCQUILKIN*KESHIA****MI*21343887~
DMG*D8*19900519*F~
DTP*291*RD8*20260713-20261011~
EQ*42~
EQ*30~
SE*14*000049059~
GE*1*49059~
IEA*1*000049059~