ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *250905*1709*^*00501*000031864*0*P*>~
GS*HS*63092*63092*250905*1709*1487113239*X*005010X279A1~
ST*270*000031864*005010X279A1~
BHT*0022*13*000031864*2509248*1709~
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*JORDAN*FRANCES****MI*35200053~
DMG*D8*19321018*F~
DTP*291*RD8*20250905-20251204~
EQ*42~
EQ*30~
SE*14*000031864~
GE*1*31864~
IEA*1*000031864~