ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *251008*1110*^*00501*000033696*0*P*>~
GS*HS*63092*63092*251008*1110*1487113239*X*005010X279A1~
ST*270*000033696*005010X279A1~
BHT*0022*13*000033696*2510281*1110~
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*BURTON*ROBERT****MI*35779195~
DMG*D8*19591119*M~
DTP*291*RD8*20251008-20260106~
EQ*42~
EQ*30~
SE*14*000033696~
GE*1*33696~
IEA*1*000033696~