ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *251003*1710*^*00501*000004133*0*P*>~
GS*HS*52095*52095*251003*1710*1487113239*X*005010X279A1~
ST*270*000004133*005010X279A1~
BHT*0022*13*000004133*2510276*1710~
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*KIRSCHENHOFER*ALLEN****MI*14217669~
DMG*D8*19641203*M~
DTP*291*RD8*20251003-20260101~
EQ*42~
EQ*30~
SE*14*000004133~
GE*1*4133~
IEA*1*000004133~