ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260112*0801*^*00501*000038849*0*P*>~
GS*HS*52095*52095*260112*0801*1487113239*X*005010X279A1~
ST*270*000038849*005010X279A1~
BHT*0022*13*000038849*260112*0801~
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*KANAREK*HAROLD****MI*01241789~
DMG*D8*19440219*M~
DTP*291*RD8*20260112-20260412~
EQ*42~
EQ*30~
SE*14*000038849~
GE*1*38849~
IEA*1*000038849~