ISA*00*          *00*          *ZZ*600095         *ZZ*600095         *251017*1110*^*00501*000034208*0*P*>~
GS*HS*600095*600095*251017*1110*1487113239*X*005010X279A1~
ST*270*000034208*005010X279A1~
BHT*0022*13*000034208*2510290*1110~
HL*1**20*1~
NM1*PR*2*CIGNA HEALTH SPRING MEDICARE PPO ADVANTAGE*****PI*10158~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*THOMAS*BERNICE****MI*10046414~
DMG*D8*19430925*M~
DTP*291*RD8*20251017-20260115~
EQ*42~
EQ*30~
SE*14*000034208~
GE*1*34208~
IEA*1*000034208~