ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260323*0803*^*00501*000042646*0*P*>~
GS*HS*52095*52095*260323*0803*1487113239*X*005010X279A1~
ST*270*000042646*005010X279A1~
BHT*0022*13*000042646*260382*0803~
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*SAVINO*MICHELE****MI*651288148~
DMG*D8*19541207*F~
DTP*291*RD8*20260323-20260621~
EQ*42~
EQ*30~
SE*14*000042646~
GE*1*42646~
IEA*1*000042646~

