ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *251022*1010*^*00501*000034398*0*P*>~
GS*HS*63092*63092*251022*1010*1487113239*X*005010X279A1~
ST*270*000034398*005010X279A1~
BHT*0022*13*000034398*2510295*1010~
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*CUSTER*JEAN****MI*32371162~
DMG*D8*19340905*F~
DTP*291*RD8*20251022-20260120~
EQ*42~
EQ*30~
SE*14*000034398~
GE*1*34398~
IEA*1*000034398~