ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *260909*1109*^*00501*000050479*0*P*>~
GS*HS*63092*63092*260909*1109*1487113239*X*005010X279A1~
ST*270*000050479*005010X279A1~
BHT*0022*13*000050479*2609252*1109~
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*THOMAS*EVELYN****MI*10018997~
DMG*D8*19330424*F~
DTP*291*RD8*20260909-20261208~
EQ*42~
EQ*30~
SE*14*000050479~
GE*1*50479~
IEA*1*000050479~