[Oscar] 820 ICHRA - Health Insurance Exchange Related Payments (X306)

ISA*00*          *00*          *ZZ*SENDER         *ZZ*RECEIVER       *240221*1259*^*00501*000000001*0*T*>~
GS*RA*SENDER*RECEIVER*20240701*125918*000000001*X*005010X306~
ST*820*0001*005010X306~
BPR*I*1100*C*ACH*CCP*******01*199999999*DA*987654321*20240701~
TRN*3*78905~
N1*PE*Oscar*FI*11111111~
N1*RM*Thatch*58*22222222~
ENT*1~
NM1*IL*1*Doe*John****C1*mbr_01hwnmmb6qk1dhj10yaevkcb4k~
REF*POL*enrlmt_01hwnmmb6qk1dhj10yaevkcb4k~
REF*AZ*111111222222~
REF*0F*333333444444~
RMR*ZZ*APTC**600~
DTM*582****RD8*20240701-20240731~
RMR*ZZ*CSR**100~
DTM*582****RD8*20240701-20240731~
RMR*ZZ*UF**-25~
DTM*582****RD8*20240701-20240731~
ENT*2~
NM1*IL*1*Dough*Jane****C1*mbr_63u5rozdwe2725w16j0zoq24~
REF*POL*enrlmt_1iyehp8mhbsgvsrdaft1tbvv~
REF*AZ*555555666666~
REF*0F*777777888888~
RMR*ZZ*APTC**400~
DTM*582****RD8*20240701-20240731~
RMR*ZZ*CSR**50~
DTM*582****RD8*20240701-20240731~
RMR*ZZ*UF**-25~
DTM*582****RD8*20240701-20240731~
SE*28*0001~
GE*1*000000001~
IEA*1*000000001~

X12 820 [Oscar] 820 ICHRA - Health Insurance Exchange Related Payments (X306)