ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *251106*1311*^*00501*000000308*0*P*>~
GS*HS*52095*52095*251106*1311*1487113239*X*005010X279A1~
ST*270*000000308*005010X279A1~
BHT*0022*13*000000308*2511310*1311~
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*BATTLE*DELORES****MI*75267451~
DMG*D8*19550812*F~
DTP*291*RD8*20251106-20260204~
EQ*42~
EQ*30~
SE*14*000000308~
GE*1*308~
IEA*1*000000308~