ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *260925*0809*^*00501*000051205*0*P*>~
GS*HS*63092*63092*260925*0809*1487113239*X*005010X279A1~
ST*270*000051205*005010X279A1~
BHT*0022*13*000051205*2609268*0809~
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*MOHR*ELAINE****MI*36709128~
DMG*D8*19490811*F~
DTP*291*RD8*20260925-20261224~
EQ*42~
EQ*30~
SE*14*000051205~
GE*1*51205~
IEA*1*000051205~