MSH|^~\&|ADM|RCH|||202002060809||ADT^A05|4162783|D|2.2|||AL|NE
EVN|A05|202002060809||||202002060900
PID|1|FHATVIG0013217|RC00008125|RC7796|ORMTEST^CPA||19970206|M||||||||||RC001108/19|
PV1|1|P|RC-PREOP||||ZTEST^Test Provider^IM/IT^Use Only^^^^^^^^^XX|||SURG||||||||IN|||||||||||||||||||||RCH|||||202002060900|
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|||||||||ENPREIN

MSH|^~\&|ADM|RCH|||202002060812||ADT^A08|4162792|D|2.2|||AL|NE
EVN|A08|202002060812||||202002060900
PID|1|FHATVIG0013217|RC00008125|RC7796|ORMTEST^CPA||19970206|M||||||||||RC001108/19|
PV1|1|P|RC-PREOP||||ZTEST^Test Provider^IM/IT^Use Only^^^^^^^^^XX|||SURG||||||||IN|||||||||||||||||||||RCH|||||202002060900|
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|||||||||EDPREIN

