ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *260102*1101*^*00501*000001562*0*P*>~
GS*HS*63092*63092*260102*1101*1487113239*X*005010X279A1~
ST*270*000001562*005010X279A1~
BHT*0022*13*000001562*260102*1101~
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*BROOKS*LORETTA****MI*36470341~
DMG*D8*19481128*F~
DTP*291*RD8*20260102-20260402~
EQ*42~
EQ*30~
SE*14*000001562~
GE*1*1562~
IEA*1*000001562~