ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260718*1207*^*00501*000049237*0*P*>~
GS*HS*52095*52095*260718*1207*1487113239*X*005010X279A1~
ST*270*000049237*005010X279A1~
BHT*0022*13*000049237*2607199*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*BLACK*KIM****MI*75289866~
DMG*D8*19550913*M~
DTP*291*RD8*20260718-20261016~
EQ*42~
EQ*30~
SE*14*000049237~
GE*1*49237~
IEA*1*000049237~