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GS*HC*52095*52095*20260716*1704*0448*X*005010X223A2~
ST*837*170448*005010X223A2~
BHT*0019*00*000004*20260716*1704*CH~
NM1*41*2*HOMECENTRIS HEALTHCARE LLC*****46*833992125~
PER*IC*MATT AUMAN*TE*4103218448~
NM1*40*2*KAISER PERMANENTE*****46*10403~
HL*1**20*1~
PRV*BI*PXC*251E00000X~
NM1*85*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
N3*10 CROSSROADS DRIVE, SUITE 102~
N4*OWINGS MILLS*MD*211178284~
REF*EI*833992125~
PER*IC*MATT AUMAN*TE*4103218448~
HL*2*1*22*0~
SBR*P*18*******CI~
NM1*IL*1*ROSS*DIANA****MI*61105501~
N3*1508 RIDGE FOREST WAY~
N4*HANOVER*MD*21076~
DMG*D8*19510719*F~
NM1*PR*2*KAISER PERMANENTE*****PI*10403~
N3*2101 E. JOPPA STEET~
N4*ROCKVILLE*MD*208529999~
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DTP*434*RD8*20260326-20260326~
DTP*435*DT*202602070001~
CL1*9*5*30~
REF*G1*1720571612-1~
HI*ABK>I70234~
HI*ABF>L97411*ABF>M349*ABF>J449*ABF>I10*ABF>E785*ABF>I6523*ABF>I2510*ABF>E039*ABF>M170*ABF>F17210*ABF>Z7901*ABF>Z951*ABF>Z952*ABF>Z860101~
HI*BH>50>D8>20260207~
NM1*71*1*YASMIN*UMME****XX*1164702874~
LX*1~
SV2*0421*HC>G0151*700.00*UN*1~
DTP*472*D8*20260326~
SE*34*170448~
GE*1*0448~
IEA*1*716170448~