ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260905*1209*^*00501*000050421*0*P*>~
GS*HS*52095*52095*260905*1209*1487113239*X*005010X279A1~
ST*270*000050421*005010X279A1~
BHT*0022*13*000050421*2609248*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*ALLEN*VICTORIA****MI*69177128~
DMG*D8*19550827*F~
DTP*291*RD8*20260905-20261204~
EQ*42~
EQ*30~
SE*14*000050421~
GE*1*50421~
IEA*1*000050421~