ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *251204*1512*^*00501*000036558*0*P*>~
GS*HS*63092*63092*251204*1512*1487113239*X*005010X279A1~
ST*270*000036558*005010X279A1~
BHT*0022*13*000036558*2512338*1512~
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*SCOTT*WAYNE****MI*33459224~
DMG*D8*19470111*M~
DTP*291*RD8*20251204-20260304~
EQ*42~
EQ*30~
SE*14*000036558~
GE*1*36558~
IEA*1*000036558~