ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260818*1308*^*00501*000050060*0*P*>~
GS*HS*52095*52095*260818*1308*1487113239*X*005010X279A1~
ST*270*000050060*005010X279A1~
BHT*0022*13*000050060*2608230*1308~
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*NGUYEN*NHUNG****MI*52201574~
DMG*D8*19691007*F~
DTP*291*RD8*20260818-20261116~
EQ*42~
EQ*30~
SE*14*000050060~
GE*1*50060~
IEA*1*000050060~