ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *260810*0808*^*00501*000049917*0*P*>~
GS*HS*63092*63092*260810*0808*1487113239*X*005010X279A1~
ST*270*000049917*005010X279A1~
BHT*0022*13*000049917*2608222*0808~
HL*1**20*1~
NM1*PR*2*CIGNA HEALTH SPRING  MEDICARE HMO ADVANTAGE*****PI*14120~
HL*2*1*21*1~
NM1*1P*2*HOMECENTRIS HEALTHCARE LLC*****XX*1487113239~
HL*3*2*22*0~
NM1*IL*1*WILLIAMS*MARY****MI*35793523~
DMG*D8*19441015*F~
DTP*291*RD8*20260810-20261108~
EQ*42~
EQ*30~
SE*14*000049917~
GE*1*49917~
IEA*1*000049917~