ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *251007*1710*^*00501*000032668*0*P*>~
GS*HS*52095*52095*251007*1710*1487113239*X*005010X279A1~
ST*270*000032668*005010X279A1~
BHT*0022*13*000032668*2510280*1710~
HL*1**20*1~
NM1*PR*2*KAISER PERMANENTE ADVANTAGE - PT SAFETY ASSESSMENT*****PI*10403~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*ESZES*JUDITH****MI*231288465~
DMG*D8*19351202*F~
DTP*291*RD8*20251007-20260105~
EQ*42~
EQ*30~
SE*14*000032668~
GE*1*32668~
IEA*1*000032668~