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GS*HS*52095*52095*260720*0707*1487113239*X*005010X279A1~
ST*270*000049250*005010X279A1~
BHT*0022*13*000049250*2607201*0707~
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*QURESHI*FOUZIA****MI*12212703~
DMG*D8*19681010*F~
DTP*291*RD8*20260720-20261018~
EQ*42~
EQ*30~
SE*14*000049250~
GE*1*49250~
IEA*1*000049250~