ISA*00*          *00*          *ZZ*52095          *ZZ*52095          *260923*1009*^*00501*000051162*0*P*>~
GS*HS*52095*52095*260923*1009*1487113239*X*005010X279A1~
ST*270*000051162*005010X279A1~
BHT*0022*13*000051162*2609266*1009~
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*GOLDBERG*DEBRA****MI*62132079~
DMG*D8*19590504*M~
DTP*291*RD8*20260923-20261222~
EQ*42~
EQ*30~
SE*14*000051162~
GE*1*51162~
IEA*1*000051162~