ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *260122*1501*^*00501*000039305*0*P*>~
GS*HS*63092*63092*260122*1501*1487113239*X*005010X279A1~
ST*270*000039305*005010X279A1~
BHT*0022*13*000039305*260122*1501~
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*SABEK*HELEN****MI*3225663211~
DMG*D8*19421214*M~
DTP*291*RD8*20260122-20260422~
EQ*42~
EQ*30~
SE*14*000039305~
GE*1*39305~
IEA*1*000039305~