ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260803*1008*^*00501*000049537*0*P*>~
GS*HS*52095*52095*260803*1008*1487113239*X*005010X279A1~
ST*270*000049537*005010X279A1~
BHT*0022*13*000049537*2608215*1008~
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*CUEVAS MINAYA*RINA****MI*15254871~
DMG*D8*19620316*F~
DTP*291*RD8*20260803-20261101~
EQ*42~
EQ*30~
SE*14*000049537~
GE*1*49537~
IEA*1*000049537~