MSH|^~\&|ADM|ARH|||201912271017||ADT^A08|4133758|D|2.2|||AL|NE
EVN|A08|201912271017||||201912271014
PID|1|FHATVIG0002444|AB00008436|CM1011|CWSTRAIN^GRAPES||19451025|M|||3439 19 ST^^HOPE^BC^V0K 6J3|||||||AB000850/19|9876197099
PV1|1|O|AB.GDCIV||||ZTEST^Test Provider^IM/IT^Use Only^^^^^^^^^XX|||||||||||RCR|||||||||||||||||||||ARH|||||201912271014|
PV2|||
OBX|1|TX|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N||||||F
ZFD|TEST,FREE TEXT PROVIDER||||ZTEST^Test Provider^IM/IT^Use Only^^^^500001^DOC|
ZFH|LUMED||||||

