ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *251112*1111*^*00501*000025222*0*P*>~
GS*HS*63092*63092*251112*1111*1487113239*X*005010X279A1~
ST*270*000025222*005010X279A1~
BHT*0022*13*000025222*2511316*1111~
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*ULLE*RICHARD****MI* 10050013~
DMG*D8*19530329*M~
DTP*291*RD8*20251112-20260210~
EQ*42~
EQ*30~
SE*14*000025222~
GE*1*25222~
IEA*1*000025222~