ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *260130*1601*^*00501*000039495*0*P*>~
GS*HS*63092*63092*260130*1601*1487113239*X*005010X279A1~
ST*270*000039495*005010X279A1~
BHT*0022*13*000039495*260130*1601~
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*CARR*MARY****MI*36503993~
DMG*D8*19670129*M~
DTP*291*RD8*20260130-20260430~
EQ*42~
EQ*30~
SE*14*000039495~
GE*1*39495~
IEA*1*000039495~