ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260904*1209*^*00501*000050407*0*P*>~
GS*HS*52095*52095*260904*1209*1487113239*X*005010X279A1~
ST*270*000050407*005010X279A1~
BHT*0022*13*000050407*2609247*1209~
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*KINGWOOD*ESSIE****MI*56302693~
DMG*D8*19450413*F~
DTP*291*RD8*20260904-20261203~
EQ*42~
EQ*30~
SE*14*000050407~
GE*1*50407~
IEA*1*000050407~