MSH|^~\&|ADM|SMH|||201911281608||ADT^A04|4117197|D|2.2|||AL|NE
EVN|A04|201911281608||||201911281606
PID|1|FHATVIG0012665|SM00047086|SM46866|PHATEST^LUMED8||19690601|F|||13750 96 AVE^^SURREY^BC^V3V 1Z2|||||||SM003700/19|
PV1|1|O|SM.RD||||ZTEST^Test Provider^IM/IT^Use Only^^^^^^^^^XX|||||||||||REF|||||||||||||||||||||SMH|||||201911281606|
PV2|||
OBX|1|TX|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N||||||F
ZFD|ZTEST^Test Provider^IM/IT^Use Only^^^^500001^DOC||||ZTEST^Test Provider^IM/IT^Use Only^^^^500001^DOC|
ZFH|LUMED||||||

