ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *251022*0810*^*00501*000034381*0*P*>~
GS*HS*52095*52095*251022*0810*1487113239*X*005010X279A1~
ST*270*000034381*005010X279A1~
BHT*0022*13*000034381*2510295*0810~
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*SCHMIDT*SANFORD****MI*381153186~
DMG*D8*19470927*M~
DTP*291*RD8*20251022-20260120~
EQ*42~
EQ*30~
SE*14*000034381~
GE*1*34381~
IEA*1*000034381~

