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GS*HS*52095*52095*250723*1207*1487113239*X*005010X279A1~
ST*270*000029581*005010X279A1~
BHT*0022*13*000029581*2507204*1207~
HL*1**20*1~
NM1*PR*2*KAISER PERMANENTE COMMERCIAL - 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*MARKS*WHARTON****MI*961056340~
DMG*D8*19571209*M~
DTP*291*RD8*20250723-20251021~
EQ*42~
EQ*30~
SE*14*000029581~
GE*1*29581~
IEA*1*000029581~