ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *251030*1510*^*00501*000034776*0*P*>~
GS*HS*63092*63092*251030*1510*1487113239*X*005010X279A1~
ST*270*000034776*005010X279A1~
BHT*0022*13*000034776*2510303*1510~
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*POWELL*VANESSA****MI*35448620~
DMG*D8*19610411*F~
DTP*291*RD8*20251030-20260128~
EQ*42~
EQ*30~
SE*14*000034776~
GE*1*34776~
IEA*1*000034776~

