ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *251205*1212*^*00501*000035489*0*P*>~
GS*HS*52095*52095*251205*1212*1487113239*X*005010X279A1~
ST*270*000035489*005010X279A1~
BHT*0022*13*000035489*2512339*1212~
HL*1**20*1~
NM1*PR*2*KAISER PERMANENTE*****PI*10403~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*BELLE*DEBORAH****MI*661024605~
DMG*D8*19621003*F~
DTP*291*RD8*20251205-20260305~
EQ*42~
EQ*30~
SE*14*000035489~
GE*1*35489~
IEA*1*000035489~

