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GS*HS***260331*1603*1073904009*X*005010X279A1~
ST*270*000001972*005010X279A1~
BHT*0022*13*000001972*260390*1603~
HL*1**20*1~
NM1*PR*2*BCBS CAREFIRST*****PI*600110~
HL*2*1*21*1~
NM1*1P*2*GRACE HOME HEALTHCARE, LLC*****XX*1073904009~
HL*3*2*22*0~
NM1*IL*1*YOUNG*KATHERINE****MI*CIH901715790~
DMG*D8*19580816*F~
DTP*291*RD8*20260331-20260629~
EQ*42~
EQ*30~
SE*14*000001972~
GE*1*1972~
IEA*1*000001972~