ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *251126*1311*^*00501*000036378*0*P*>~
GS*HS*63092*63092*251126*1311*1487113239*X*005010X279A1~
ST*270*000036378*005010X279A1~
BHT*0022*13*000036378*2511330*1311~
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*SMITH*DEON****MI*30029905~
DMG*D8*19800716*F~
DTP*291*RD8*20251126-20260224~
EQ*42~
EQ*30~
SE*14*000036378~
GE*1*36378~
IEA*1*000036378~