ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *251224*1112*^*00501*000037781*0*P*>~
GS*HS*63092*63092*251224*1112*1487113239*X*005010X279A1~
ST*270*000037781*005010X279A1~
BHT*0022*13*000037781*2512358*1112~
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*WEICHSELDORFER*MARY****MI*35806675~
DMG*D8*19730419*F~
DTP*291*RD8*20251224-20260324~
EQ*42~
EQ*30~
SE*14*000037781~
GE*1*37781~
IEA*1*000037781~