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GS*HS*52095*52095*260910*1809*1487113239*X*005010X279A1~
ST*270*000050698*005010X279A1~
BHT*0022*13*000050698*2609253*1809~
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*NKENGAFAC*ASHU ESTHER****MI*13297773~
DMG*D8*19580810*F~
DTP*291*RD8*20260910-20261209~
EQ*42~
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GE*1*50698~
IEA*1*000050698~