How do we send dynamic flag HID events?

I see that apple provides dynamic flags here: https://opensource.apple.com/source/IOHIDFamily/IOHIDFamily-34.1.1/IOHIDSystem/IOKit/hidsystem/IOHIDUsageTables.h.auto.html In page (0x07).

I can send a HID using appium for now, using this command in python:

self.driver.execute_script("mobile: performIoHidEvent", {"page": 0x07, "usage": 0xE0, "durationSeconds": 0.5})

But I cannot send dynamic flags to do a CMD.+ Combinations or shift + combinations.

I would like know if there is any other way I can do multi-key operations such as CMD + A, CMD + C etc.