MSH|^~\&|ADM|CGH|||202001091530||ADT^A04|4143242|D|2.2|||AL|NE
EVN|A04|202001091530||||202001091530
PID|1|FHATVIG0012999|CG00002254|CG2221|ITSTEST^Holly||19650109|F|||555 WEST FIFTH AVE^^ROSEDALE^BC^BC|||||||CG000060/19|
PV1|1|O|CG.ASTHMA||||ZTEST^Test Provider^IM/IT^Use Only^^^^^^^^^XX|||||||||||CLI|||||||||||||||||||||CGH|||||202001091530|
PV2|||
OBX|1|TX|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N||||||F
ZFD|ZTESTDOC^ZTESTDOC^IM/IT^Use ONLY^^^^0^DOC||||ZTEST^Test Provider^IM/IT^Use Only^^^^500001^DOC||||ZTESTTRANS^TEST^TRANS^^^^MD^^DOC
ZFH|LUMED||||||

