ISA*00*          *00*          *ZZ*CADHCS_5010_834*30*999999991      *250124*1927*^*00501*000000001*0*P*:~GS*BE*CADHCS_5010_834*999999991*20250124*192730*10000001*X*005010X220A1~ST*834*0001*005010X220A1~BGN*00*DHCS834-DA-20250124-Sample PACE-001*20250124*19273000****2~QTY*TO*1~N1*P5*California Department of Health Care Services.........*FI*999999990~N1*IN*Sample PACE Inc.*FI*999999991~INS*Y*18*001*AI*A*E**AC~REF*0F*randomParticipantID~REF*1L*randomCIN1~REF*17*;;202501;~REF*23*4;20200101;;~REF*3H*19;10;randomCaseNum1;;~REF*6O*;W;Y;;60;~REF*ZZ*01051;41609;;;;30451;41651;;;~NM1*IL*1*randomLastName*randomFirstName*A~PER*IP**TE*randomPhone~N3*randomStreetAddress1~N4*LOS ANGELES CA*CA*90019**CY*19~DMG*D8*randomDoB*F**7~LUI*LD*SPA**7~HD*021**LTC*010;51~DTP*348*D8*20250101~DTP*349*D8*20250131~REF*17*N;;;;;;;;;;;;;1~REF*9V*9;9;0~REF*CE*10;401;;;;;;~REF*RB*10~REF*ZX*19~REF*ZZ*;;10~SE*29*0001~GE*1*10000001~IEA*1*000000001~
