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BHT*0022*13*000001509*2606159*1206~
HL*1**20*1~
NM1*PR*2*UNITED HEALTH CARE MCR ADVANTAGE*****PI*10784~
HL*2*1*21*1~
NM1*1P*2*GRACE HOME HEALTHCARE, LLC*****XX*1073904009~
HL*3*2*22*0~
NM1*IL*1*TONG*MY****MI*126513130~
DMG*D8*19370613*F~
DTP*291*RD8*20260608-20260906~
EQ*42~
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IEA*1*000001509~