ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *260113*1301*^*00501*000038915*0*P*>~
GS*HS*63092*63092*260113*1301*1487113239*X*005010X279A1~
ST*270*000038915*005010X279A1~
BHT*0022*13*000038915*260113*1301~
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*BENNETT*THELMA****MI*10032954~
DMG*D8*19370527*F~
DTP*291*RD8*20260113-20260413~
EQ*42~
EQ*30~
SE*14*000038915~
GE*1*38915~
IEA*1*000038915~