MSH|^~\&|ADM|CGH|||202001100836||ADT^A04|4143410|D|2.2|||AL|NE
EVN|A04|202001100836||||202001100835
PID|1|FHATVIG0013002|CG00002256|CG2224|PCSTEST^OERULESREGERCGH||19750110|F|||1235-98 ST^^CILLIWACH^BC^BC|||||||CG000063/19|
PV1|1|E|CG.ER||||EDMTEST^EDM Test Provider^Upgrade^^^^^^^^^^XX|||||||||||ER|||||||||||||||||||||CGH|||||202001100835|
PV2|||TEST PATIENT FOR OE PCSREF RULES
OBX|1|CE|ADM IDSOUR^SOURCE OF ID^ADM||BCC^BC CareCard (No Photo ID)||||||F
OBX|2|CE|ADM MDRO2^Canada in the last 12 months?^ADM||N^NO||||||F
OBX|3|CE|ADM MDRO4^Bangladesh or Vietnam in the last 12 months?^ADM||N^NO||||||F
OBX|4|CE|ADM MRSA2^correctional/shelter in the last 12 months?^ADM||N^NO||||||F
OBX|5|CE|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N^NO||||||F
ZFD|EDMTEST^EDM Test Provider^Upgrade^^^^^^DOC||EDMTEST^EDM Test Provider^Upgrade^^^^^^DOC|
ZFH|LUMED||||||

