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ST*270*000032268*005010X279A1~
BHT*0022*13*000032268*2510281*1510~
HL*1**20*1~
NM1*PR*2*KAISER PERMANENTE ADVANTAGE - PT SAFETY ASSESSMENT*****PI*10403~
HL*2*1*21*1~
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HL*3*2*22*0~
NM1*IL*1*SCOTT*DEAN****MI*32301366~
DMG*D8*19640331*M~
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IEA*1*000032268~