ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260902*1409*^*00501*000050369*0*P*>~
GS*HS*52095*52095*260902*1409*1487113239*X*005010X279A1~
ST*270*000050369*005010X279A1~
BHT*0022*13*000050369*2609245*1409~
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*SCOTT*SANDRA****MI*	16165330~
DMG*D8*19470831*M~
DTP*291*RD8*20260902-20261201~
EQ*42~
EQ*30~
SE*14*000050369~
GE*1*50369~
IEA*1*000050369~