ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *250911*1509*^*00501*000028036*0*P*>~
GS*HS*63092*63092*250911*1509*1487113239*X*005010X279A1~
ST*270*000028036*005010X279A1~
BHT*0022*13*000028036*2509254*1509~
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*GRAY*MARGUERITE****MI*32103254~
DMG*D8*19260307*F~
DTP*291*RD8*20250911-20251210~
EQ*42~
EQ*30~
SE*14*000028036~
GE*1*28036~
IEA*1*000028036~