ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *251030*1610*^*00501*000034780*0*P*>~
GS*HS*63092*63092*251030*1610*1487113239*X*005010X279A1~
ST*270*000034780*005010X279A1~
BHT*0022*13*000034780*2510303*1610~
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*INGRAO*MITZI****MI*36563048~
DMG*D8*19471105*F~
DTP*291*RD8*20251030-20260128~
EQ*42~
EQ*30~
SE*14*000034780~
GE*1*34780~
IEA*1*000034780~