ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *250825*1508*^*00501*000025831*0*P*>~
GS*HS*63092*63092*250825*1508*1487113239*X*005010X279A1~
ST*270*000025831*005010X279A1~
BHT*0022*13*000025831*2508237*1508~
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*JENNINGS*SHIRLEY****MI*36684340~
DMG*D8*19500216*M~
DTP*291*RD8*20250825-20251123~
EQ*42~
EQ*30~
SE*14*000025831~
GE*1*25831~
IEA*1*000025831~

