ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260807*0908*^*00501*000049889*0*P*>~
GS*HS*52095*52095*260807*0908*1487113239*X*005010X279A1~
ST*270*000049889*005010X279A1~
BHT*0022*13*000049889*2608219*0908~
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*ABDUL-RAHEEM*ANDRE****MI*44205487~
DMG*D8*19600302*M~
DTP*291*RD8*20260807-20261105~
EQ*42~
EQ*30~
SE*14*000049889~
GE*1*49889~
IEA*1*000049889~