MSH|^~\&|ADM|RCH|||201912031521||ADT^A05|4122789|D|2.2|||AL|NE
EVN|A05|201912031521||||201912031815
PID|1|FHATVIG0006957|RC00007952|SM43379|CPATEST^DUNNOCKK^TEST||19640404|F||||||||||RC000875/19|
PV1|1|P|RC.OR||||ORMDOC^ORMDOC^TESTSURG^^^^^^^^^^XX|||||||||||SDC|||||||||||||||||||||RCH|||||201912031815|
PV2|||
OBX|1|TX|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N||||||F
AL1|1|DA|F006002174^dexamethasone|MO|Hallucinations        ADR|20181210
ZFD|||||ORMDOC^ORMDOC^TESTSURG^^^^^123456^DOC|
ZFH|LUMED||||||

