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GS*HS*52095*52095*251217*0912*1487113239*X*005010X279A1~
ST*270*000037573*005010X279A1~
BHT*0022*13*000037573*2512351*0912~
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*COLE*DANIELLE****MI*	18270364~
DMG*D8*19730902*M~
DTP*291*RD8*20251217-20260317~
EQ*42~
EQ*30~
SE*14*000037573~
GE*1*37573~
IEA*1*000037573~