ISA*00*          *00*          *ZZ*63092          *ZZ*63092          *260927*1209*^*00501*000051224*0*P*>~
GS*HS*63092*63092*260927*1209*1487113239*X*005010X279A1~
ST*270*000051224*005010X279A1~
BHT*0022*13*000051224*2609270*1209~
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*DRAYER*BETTIE****MI*10057921~
DMG*D8*19420111*M~
DTP*291*RD8*20260927-20261226~
EQ*42~
EQ*30~
SE*14*000051224~
GE*1*51224~
IEA*1*000051224~