ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *251222*1212*^*00501*000037711*0*P*>~
GS*HS*63092*63092*251222*1212*1487113239*X*005010X279A1~
ST*270*000037711*005010X279A1~
BHT*0022*13*000037711*2512356*1212~
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*FOUNTAIN*PHYLLIS****MI*33469859~
DMG*D8*19460305*F~
DTP*291*RD8*20251222-20260322~
EQ*42~
EQ*30~
SE*14*000037711~
GE*1*37711~
IEA*1*000037711~