ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *260609*1306*^*00501*000047573*0*P*>~
GS*HS*63092*63092*260609*1306*1487113239*X*005010X279A1~
ST*270*000047573*005010X279A1~
BHT*0022*13*000047573*2606160*1306~
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*FOGLE*MARY****MI*35197453~
DMG*D8*19371124*F~
DTP*291*RD8*20260609-20260907~
EQ*42~
EQ*30~
SE*14*000047573~
GE*1*47573~
IEA*1*000047573~

