ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *250807*1508*^*00501*000030430*0*P*>~
GS*HS*63092*63092*250807*1508*1487113239*X*005010X279A1~
ST*270*000030430*005010X279A1~
BHT*0022*13*000030430*2508219*1508~
HL*1**20*1~
NM1*PR*2*CIGNA HEALTH SPRING  MEDICARE HMO ADVANTAGE*****PI*10158~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*MANGRUM*SEAN****MI*36352793~
DMG*D8*19651018*M~
DTP*291*RD8*20250807-20251105~
EQ*42~
EQ*30~
SE*14*000030430~
GE*1*30430~
IEA*1*000030430~