ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260919*1609*^*00501*000051050*0*P*>~
GS*HS*52095*52095*260919*1609*1487113239*X*005010X279A1~
ST*270*000051050*005010X279A1~
BHT*0022*13*000051050*2609262*1609~
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*BURROWS*CORIN****MI*76311501~
DMG*D8*19570606*F~
DTP*291*RD8*20260919-20261218~
EQ*42~
EQ*30~
SE*14*000051050~
GE*1*51050~
IEA*1*000051050~