ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *250919*1709*^*00501*000032645*0*P*>~
GS*HS*63092*63092*250919*1709*1487113239*X*005010X279A1~
ST*270*000032645*005010X279A1~
BHT*0022*13*000032645*2509262*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*SIMMS*MARY****MI*36800983~
DMG*D8*19590621*F~
DTP*291*RD8*20250919-20251218~
EQ*42~
EQ*30~
SE*14*000032645~
GE*1*32645~
IEA*1*000032645~

