ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *251030*0810*^*00501*000028979*0*P*>~
GS*HS*63092*63092*251030*0810*1487113239*X*005010X279A1~
ST*270*000028979*005010X279A1~
BHT*0022*13*000028979*2510303*0810~
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*DUBOSE*ELTON****MI*35834393~
DMG*D8*19530726*M~
DTP*291*RD8*20251030-20260128~
EQ*42~
EQ*30~
SE*14*000028979~
GE*1*28979~
IEA*1*000028979~