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GS*HS*52095*52095*260708*1707*1487113239*X*005010X279A1~
ST*270*000046692*005010X279A1~
BHT*0022*13*000046692*2607189*1707~
HL*1**20*1~
NM1*PR*2*KAISER PERMANENTE COMMERCIAL JOINT*****PI*10403~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*TYLER*LAMONTE****MI*62180940~
DMG*D8*19720815*M~
DTP*291*RD8*20260708-20261006~
EQ*42~
EQ*30~
SE*14*000046692~
GE*1*46692~
IEA*1*000046692~