MSH|^~\&|ADM|SMH|||202001271105||ADT^A08|4156926|D|2.2|||AL|NE
EVN|A08|202001271105||||201909041327
PID|1|FHATVIG0010844|SM00045695|SM45493|ITSTEST^BALVINDER||19600101|M|||15234 123 ST^^SURREY^BC^V3S 3L6|||||||SM001937/19|9875075246
PV1|1|I|SM-N42^SMN42-018^A|EL|||ZTEST^Test Provider^IM/IT^Use Only^^^^^^^^^XX|||INTM||||||||IN|||||||||||||||||||||SMH|||||201909041327|
PV2||P^Private - Non-Solicited|
OBX|1|TX|ADM CURRES^Residing at current add. since (DD/MM/YY)^ADM||19600101||||||F
OBX|2|CE|ADM IDSOUR^SOURCE OF ID^ADM||NONE^None||||||F
OBX|3|CE|ADM MDRO2^Canada in the last 12 months?^ADM||N^NO||||||F
OBX|4|CE|ADM MDRO4^Bangladesh or Vietnam in the last 12 months?^ADM||N^NO||||||F
OBX|5|CE|ADM MRSA2^correctional/shelter in the last 12 months?^ADM||N^NO||||||F
OBX|6|TX|RTCOPDDATE^Date of Exacerbation Symptom Reversal:^ADM||20191008||||||F
OBX|7|TX|RTCOPDDX^Confirmed COPD Diagnosis via PFT:^ADM||Y||||||F
OBX|8|TX|RTCOPDPFT^PFT Date:^ADM||20191008||||||F
OBX|9|CE|RTCOPDPPO^COPD PPO:^ADM||1^Unknown||||||F
OBX|10|CE|RTCOPDREF1^Referral Complete:^ADM||1^No||||||F
OBX|11|TX|RTCOPDTIME^Time of Exacerbation Symptom Reversal:^ADM||1015||||||F
OBX|12|TX|RTEXACSR^Exacerbation Symptom Reversal:^ADM||Y||||||F
OBX|13|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|ZTEST^Test Provider^IM/IT^Use Only^^^^500001^DOC|
ZFH|LUMED||||||

