ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *260521*0905*^*00501*000046177*0*P*>~
GS*HS*63092*63092*260521*0905*1487113239*X*005010X279A1~
ST*270*000046177*005010X279A1~
BHT*0022*13*000046177*2605141*0905~
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*JACOB-ALEXANDER*DORIS****MI*32705826~
DMG*D8*19370701*F~
DTP*291*RD8*20260521-20260819~
EQ*42~
EQ*30~
SE*14*000046177~
GE*1*46177~
IEA*1*000046177~

