ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *251015*1110*^*00501*000000492*0*P*>~
GS*HS*63092*63092*251015*1110*1487113239*X*005010X279A1~
ST*270*000000492*005010X279A1~
BHT*0022*13*000000492*2510288*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*ROSS*RENA****MI*36666596~
DMG*D8*19530620*F~
DTP*291*RD8*20251015-20260113~
EQ*42~
EQ*30~
SE*14*000000492~
GE*1*492~
IEA*1*000000492~