ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *251110*1011*^*00501*000035449*0*P*>~
GS*HS*52095*52095*251110*1011*1487113239*X*005010X279A1~
ST*270*000035449*005010X279A1~
BHT*0022*13*000035449*2511314*1011~
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*APFEL*MARILYN****MI*081094291~
DMG*D8*19450225*F~
DTP*291*RD8*20251110-20260208~
EQ*42~
EQ*30~
SE*14*000035449~
GE*1*35449~
IEA*1*000035449~