ISA*00*          *00*          *ZZ*DHCS           *ZZ*HEALTHPLAN     *250108*1430*^*00501*000000001*0*P*:~GS*BE*DHCS*HEALTHPLAN*20250108*1430*1*X*005010X220A1~ST*834*0001*005010X220A1~BGN*00*12345*20250108*1430****2~REF*38*MEDI-CAL~DTP*007*D8*20250108~N1*P5*CALIFORNIA DHCS*FI*953654321~N1*IN*HEALTH PLAN NAME*FI*987654321~INS*Y*18*021***FT***AC~REF*0F*MBR001~REF*6P*1A23BC456D7~REF*1D*MC123456789~REF*ABB*QMBPLUS~NM1*IL*1*GARCIA*MARIA*R***MI*MBR001~PER*IP**HP*5555551234~N3*123 MAIN ST~N4*LOS ANGELES*CA*90001~DMG*D8*19550315*F~HD*021**HLT*MEDICARE ADVANTAGE D-SNP~DTP*348*D8*20240101~HD*021**HLT*MEDI-CAL~DTP*348*D8*20240101~INS*Y*18*001***FT***AC~REF*0F*MBR002~REF*6P*2B34CD567E8~REF*1D*MC987654321~REF*AB*4M~NM1*IL*1*JOHNSON*ROBERT*L***MI*MBR002~N3*456 OAK AVE~N4*SAN DIEGO*CA*92101~DMG*D8*19600822*M~HD*001**HLT*MEDICARE PART C~DTP*348*D8*20230515~HD*001**HLT*MEDI-CAL~DTP*348*D8*20240101~INS*Y*18*024***FT***TE~REF*0F*MBR003~REF*6P*3C45DE678F9~REF*1D*MC555666777~REF*ABB*SLMBPLUS~NM1*IL*1*RODRIGUEZ*CARMEN****MI*MBR003~N3*789 PINE RD~N4*SACRAMENTO*CA*95814~DMG*D8*19481203*F~HD*024**HLT*MEDICARE PART A~DTP*348*D8*20220101~DTP*349*D8*20250228~HD*024**HLT*MEDI-CAL~DTP*348*D8*20220101~DTP*349*D8*20250228~INS*Y*18*021***FT***AC~REF*0F*MBR004~REF*1D*MC111222333~NM1*IL*1*NGUYEN*THANH*H***MI*MBR004~N3*321 ELM ST~N4*SAN FRANCISCO*CA*94102~DMG*D8*19701015*M~HD*021**HLT*MEDI-CAL~DTP*348*D8*20250101~INS*Y*18*021***FT***AC~REF*0F*MBR005~REF*6P*5E67FG890H1~NM1*IL*1*SMITH*JOHN*A***MI*MBR005~N3*654 MAPLE AVE~N4*FRESNO*CA*93650~DMG*D8*19580710*M~HD*021**HLT*MEDICARE PART C~DTP*348*D8*20250901~SE*68*0001~GE*1*1~IEA*1*000000001~