ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *250811*1208*^*00501*000028550*0*P*>~
GS*HS*63092*63092*250811*1208*1487113239*X*005010X279A1~
ST*270*000028550*005010X279A1~
BHT*0022*13*000028550*2508223*1208~
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*DAWSON*WANDA****MI*34670537~
DMG*D8*19560308*F~
DTP*291*RD8*20250811-20251109~
EQ*42~
EQ*30~
SE*14*000028550~
GE*1*28550~
IEA*1*000028550~