ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260202*1602*^*00501*000037842*0*P*>~
GS*HS*52095*52095*260202*1602*1487113239*X*005010X279A1~
ST*270*000037842*005010X279A1~
BHT*0022*13*000037842*260233*1602~
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*GARY*VIVIAN****MI*01161066~
DMG*D8*19340917*F~
DTP*291*RD8*20260202-20260503~
EQ*42~
EQ*30~
SE*14*000037842~
GE*1*37842~
IEA*1*000037842~