ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *251001*0810*^*00501*000033076*0*P*>~
GS*HS*52095*52095*251001*0810*1487113239*X*005010X279A1~
ST*270*000033076*005010X279A1~
BHT*0022*13*000033076*2510274*0810~
HL*1**20*1~
NM1*PR*2*KAISER PERMANENTE*****PI*10403~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*SHIELDS*SHELLY****MI*071033151~
DMG*D8*19610416*F~
DTP*291*RD8*20251001-20251230~
EQ*42~
EQ*30~
SE*14*000033076~
GE*1*33076~
IEA*1*000033076~