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GS*HS*52095*52095*260307*1203*1487113239*X*005010X279A1~
ST*270*000041946*005010X279A1~
BHT*0022*13*000041946*260366*1203~
HL*1**20*1~
NM1*PR*2*KAISER PERMANENTE*****PI*10403~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*ABUL MALIK*ZXANDA****MI*461044692~
DMG*D8*19861119*F~
DTP*291*RD8*20260307-20260605~
EQ*42~
EQ*30~
SE*14*000041946~
GE*1*41946~
IEA*1*000041946~