MSH|^~\&|ITS||||201912091315||ORU^R01|4125877|D|2.3|||AL|NE
PID|1|FHATVIG0011016|SM00045816|SM45614|ITSTEST^CLOVERDALE||19950905|F||||||||||SM002085/19|9875057287
PV1|1|I
OBR|1|||||201912091301|20191209|201912091301||||||||||||OT|SM-INIT||||D||||||
OBX|1|TX|||          \H\NAME\N\:   ITSTEST,CLOVERDALE           
OBX|2|TX|||         \H\ACCT#\N\:   SM002085/19    \H\UNIT#\N\:  SM00045816     
OBX|3|TX|||         \H\ADM DT\N\:   13/09/19    \H\PHN\N\:  9875057287     
OBX|4|TX|||\H\Occupational Therapy\N\         \H\LOC\N\:   SM-3W    \H\RM/B\N\:  SM3W-334-B     
OBX|5|TX|||\H\Initial Assessment\N\         \H\DOB\N\:   05/09/1995    \H\A/S\N\:  24 F     
OBX|6|TX|||         \H\REG CAT\N\:   S.ACU           
OBX|7|TX|||         \H\ATT DR\N\:   Oedoc,Marytrain MD           
OBX|8|TX|||         \H\FAM DR\N\:   Oedoc,Marytrain MD           
OBX|9|TX|||\ZU\                                                                                                                                                                     \N\                       
OBX|10|TX|||  
OBX|11|TX|||\ZHU\Neurological Assessment - Occupational Performance Components  
OBX|12|TX|||\N\  
OBX|13|TX|||\ZHU\Cognitive Status TESTING FOR bIKRAM  
OBX|14|TX|||\N\Communication:  [*]  
OBX|15|TX|||Awareness/Insight:  [*]  
OBX|16|TX|||Orientation:  [*]  
OBX|17|TX|||Attention:  [*]  
OBX|18|TX|||Information Processing:  [*]  
OBX|19|TX|||Memory:  [*]  
OBX|20|TX|||Executive Functioning:  [*]  
OBX|21|TX|||  
OBX|22|TX|||\ZHU\Perceptual Status  
OBX|23|TX|||\N\Motor Planning:  [*]  
OBX|24|TX|||Spatial Relations:  [*]  
OBX|25|TX|||Body Schema:  [*]  
OBX|26|TX|||Left/Right Discrimination:  [*]  
OBX|27|TX|||Positioning in Space:  [*]  
OBX|28|TX|||Depth Perception:  [*]  
OBX|29|TX|||  
OBX|30|TX|||\ZHU\Vision Status  
OBX|31|TX|||\N\Glasses:  [*]  
OBX|32|TX|||Identified Issues:  [*]  
OBX|33|TX|||  
OBX|34|TX|||\ZHU\Hearing Status  
OBX|35|TX|||\N\[*]  
OBX|36|TX|||  
OBX|37|TX|||\ZHU\Physical Status  
OBX|38|TX|||\N\Hand Dominance:  [*g OTLR]  
OBX|39|TX|||  
OBX|40|TX|||Upper Extremity  
OBX|41|TX||| AROM/Strength:  [*]  
OBX|42|TX||| Sensation:  [*]  
OBX|43|TX||| Coordination:  [*]  
OBX|44|TX||| Proprioception:  [*]  
OBX|45|TX|||  
OBX|46|TX|||Balance  
OBX|47|TX||| Sit:  [*]  
OBX|48|TX||| Stand:  [*]  
OBX|49|TX|||  
OBX|50|TX|||Head \T\ Neck Control:  [*]  
OBX|51|TX|||  
OBX|52|TX|||Lower Extremity:  [*]  
OBX|53|TX|||  
OBX|54|TX|||Activity Tolerance:  [*]  
OBX|55|TX|||  
OBX|56|TX|||\ZHU\Occupational Performance Areas  
OBX|57|TX|||\N\  
OBX|58|TX|||\ZHU\Prior to Admission Self Care  
OBX|59|TX|||\N\Feeding:  [*g OTINDASST3]  
OBX|60|TX|||Washing/Bathing:  [*g OTINDASST3]  
OBX|61|TX|||Dressing:  [*g OTINDASST3]  
OBX|62|TX|||Grooming:  [*g OTINDASST3]  
OBX|63|TX|||Toileting:  [*g OTINDASST3]  
OBX|64|TX|||  
OBX|65|TX|||\ZHU\Current Self Care  
OBX|66|TX|||\N\Feeding:  [*g OTINDASST3]  
OBX|67|TX|||Washing/Bathing:  [*g OTINDASST3]  
OBX|68|TX|||Dressing:  [*g OTINDASST3]  
OBX|69|TX|||Grooming:  [*g OTINDASST3]  
OBX|70|TX|||Toileting:  [*g OTINDASST3]  
OBX|71|TX|||  
OBX|72|TX|||\ZHU\Prior Mobility  
OBX|73|TX|||\N\[*]  
OBX|74|TX|||  
OBX|75|TX|||\ZHU\Current Mobility  
OBX|76|TX|||\N\[*]  
OBX|77|TX|||  
OBX|78|TX|||\ZHU\Patient Measurements  
OBX|79|TX|||\N\Hip Width:  [*]  
OBX|80|TX|||Thigh Length:  [*]  
OBX|81|TX|||Calf Length:  [*]  
OBX|82|TX|||  
OBX|83|TX|||\ZHU\Prior to Admission Productivity:  Home Management  
OBX|84|TX|||\N\Meal Preparation:  [*g OTINDFAM]  
OBX|85|TX|||Cleaning:  [*g OTINDFAM]  
OBX|86|TX|||Laundry:  [*g OTINDFAM]  
OBX|87|TX|||  
OBX|88|TX|||\ZHU\Prior to Admission Productivity:  Community Management  
OBX|89|TX|||\N\Community Errands:  [*g OTINDFAM]  
OBX|90|TX|||Grocery Shopping:  [*g OTINDFAM]  
OBX|91|TX|||Transportation:  [*g OTINDFAM]  
OBX|92|TX|||Financial Management:  [*g OTINDFAM]  
OBX|93|TX|||Employment/Volunteering:  [*g OTINDFAM]  
OBX|94|TX|||Medication Management:  [*g OTINDFAM]  
OBX|95|TX|||  
OBX|96|TX|||\ZHU\Prior to Admission Leisure  
OBX|97|TX|||\N\[*]  
OBX|98|TX|||  
OBX|99|TX|||\ZHU\Patient and/or Family Comments and/or Concerns  
OBX|100|TX|||\N\[*]  
OBX|101|TX|||\ZHU\Impressions/ Analysis  
OBX|102|TX|||\N\[*] tESTING 2 FOR bIKRAM  
OBX|103|TX|||  
OBX|104|TX|||\ZHU\Therapy Goals  
OBX|105|TX|||\N\[*]  
OBX|106|TX|||  
OBX|107|TX|||\ZHU\Plan/ Recommendations  
OBX|108|TX|||\N\[*]  
OBX|109|TX|||  
OBX|110|TX|||Patient consent for assessment and treatment received (Y/N):  [*]  
OBX|111|TX|||  
OBX|112|TX|||  
OBX|113|TX|||\H\Pam Dawson, Occupational Therapist  
OBX|114|TX|||\N\Date/Time:  \ZU\09/12/19\N\  \ZU\1301  
OBX|115|TX|||                                                                                                                                                           
OBX|116|TX|||\H\ADDENDUM  
OBX|117|TX|||  
OBX|118|TX|||\N\This is a test for addednum and Bikram  
OBX|119|TX|||Signed By:   \ZIU\Pam Dawson  
OBX|120|TX|||\N\Date/Time:   \ZU\09/12/19\N\ \ZU\1314  

MSH|^~\&|ITS||||201912091316||ORU^R01|4125878|D|2.3|||AL|NE
PID|1|FHATVIG0011016|SM00045816|SM45614|ITSTEST^CLOVERDALE||19950905|F||||||||||SM002085/19|9875057287
PV1|1|I
OBR|1|||||201912091301|20191209|201912091301||||||||||||OT|SM-INIT||||S||||||
OBX|1|TX|||          \H\NAME\N\:   ITSTEST,CLOVERDALE           
OBX|2|TX|||         \H\ACCT#\N\:   SM002085/19    \H\UNIT#\N\:  SM00045816     
OBX|3|TX|||         \H\ADM DT\N\:   13/09/19    \H\PHN\N\:  9875057287     
OBX|4|TX|||\H\Occupational Therapy\N\         \H\LOC\N\:   SM-3W    \H\RM/B\N\:  SM3W-334-B     
OBX|5|TX|||\H\Initial Assessment\N\         \H\DOB\N\:   05/09/1995    \H\A/S\N\:  24 F     
OBX|6|TX|||         \H\REG CAT\N\:   S.ACU           
OBX|7|TX|||         \H\ATT DR\N\:   Oedoc,Marytrain MD           
OBX|8|TX|||         \H\FAM DR\N\:   Oedoc,Marytrain MD           
OBX|9|TX|||\ZU\                                                                                                                                                                     \N\                       
OBX|10|TX|||  
OBX|11|TX|||\ZHU\Neurological Assessment - Occupational Performance Components  
OBX|12|TX|||\N\  
OBX|13|TX|||\ZHU\Cognitive Status TESTING FOR bIKRAM  
OBX|14|TX|||\N\Communication:  [*]  
OBX|15|TX|||Awareness/Insight:  [*]  
OBX|16|TX|||Orientation:  [*]  
OBX|17|TX|||Attention:  [*]  
OBX|18|TX|||Information Processing:  [*]  
OBX|19|TX|||Memory:  [*]  
OBX|20|TX|||Executive Functioning:  [*]  
OBX|21|TX|||  
OBX|22|TX|||\ZHU\Perceptual Status  
OBX|23|TX|||\N\Motor Planning:  [*]  
OBX|24|TX|||Spatial Relations:  [*]  
OBX|25|TX|||Body Schema:  [*]  
OBX|26|TX|||Left/Right Discrimination:  [*]  
OBX|27|TX|||Positioning in Space:  [*]  
OBX|28|TX|||Depth Perception:  [*]  
OBX|29|TX|||  
OBX|30|TX|||\ZHU\Vision Status  
OBX|31|TX|||\N\Glasses:  [*]  
OBX|32|TX|||Identified Issues:  [*]  
OBX|33|TX|||  
OBX|34|TX|||\ZHU\Hearing Status  
OBX|35|TX|||\N\[*]  
OBX|36|TX|||  
OBX|37|TX|||\ZHU\Physical Status  
OBX|38|TX|||\N\Hand Dominance:  [*g OTLR]  
OBX|39|TX|||  
OBX|40|TX|||Upper Extremity  
OBX|41|TX||| AROM/Strength:  [*]  
OBX|42|TX||| Sensation:  [*]  
OBX|43|TX||| Coordination:  [*]  
OBX|44|TX||| Proprioception:  [*]  
OBX|45|TX|||  
OBX|46|TX|||Balance  
OBX|47|TX||| Sit:  [*]  
OBX|48|TX||| Stand:  [*]  
OBX|49|TX|||  
OBX|50|TX|||Head \T\ Neck Control:  [*]  
OBX|51|TX|||  
OBX|52|TX|||Lower Extremity:  [*]  
OBX|53|TX|||  
OBX|54|TX|||Activity Tolerance:  [*]  
OBX|55|TX|||  
OBX|56|TX|||\ZHU\Occupational Performance Areas  
OBX|57|TX|||\N\  
OBX|58|TX|||\ZHU\Prior to Admission Self Care  
OBX|59|TX|||\N\Feeding:  [*g OTINDASST3]  
OBX|60|TX|||Washing/Bathing:  [*g OTINDASST3]  
OBX|61|TX|||Dressing:  [*g OTINDASST3]  
OBX|62|TX|||Grooming:  [*g OTINDASST3]  
OBX|63|TX|||Toileting:  [*g OTINDASST3]  
OBX|64|TX|||  
OBX|65|TX|||\ZHU\Current Self Care  
OBX|66|TX|||\N\Feeding:  [*g OTINDASST3]  
OBX|67|TX|||Washing/Bathing:  [*g OTINDASST3]  
OBX|68|TX|||Dressing:  [*g OTINDASST3]  
OBX|69|TX|||Grooming:  [*g OTINDASST3]  
OBX|70|TX|||Toileting:  [*g OTINDASST3]  
OBX|71|TX|||  
OBX|72|TX|||\ZHU\Prior Mobility  
OBX|73|TX|||\N\[*]  
OBX|74|TX|||  
OBX|75|TX|||\ZHU\Current Mobility  
OBX|76|TX|||\N\[*]  
OBX|77|TX|||  
OBX|78|TX|||\ZHU\Patient Measurements  
OBX|79|TX|||\N\Hip Width:  [*]  
OBX|80|TX|||Thigh Length:  [*]  
OBX|81|TX|||Calf Length:  [*]  
OBX|82|TX|||  
OBX|83|TX|||\ZHU\Prior to Admission Productivity:  Home Management  
OBX|84|TX|||\N\Meal Preparation:  [*g OTINDFAM]  
OBX|85|TX|||Cleaning:  [*g OTINDFAM]  
OBX|86|TX|||Laundry:  [*g OTINDFAM]  
OBX|87|TX|||  
OBX|88|TX|||\ZHU\Prior to Admission Productivity:  Community Management  
OBX|89|TX|||\N\Community Errands:  [*g OTINDFAM]  
OBX|90|TX|||Grocery Shopping:  [*g OTINDFAM]  
OBX|91|TX|||Transportation:  [*g OTINDFAM]  
OBX|92|TX|||Financial Management:  [*g OTINDFAM]  
OBX|93|TX|||Employment/Volunteering:  [*g OTINDFAM]  
OBX|94|TX|||Medication Management:  [*g OTINDFAM]  
OBX|95|TX|||  
OBX|96|TX|||\ZHU\Prior to Admission Leisure  
OBX|97|TX|||\N\[*]  
OBX|98|TX|||  
OBX|99|TX|||\ZHU\Patient and/or Family Comments and/or Concerns  
OBX|100|TX|||\N\[*]  
OBX|101|TX|||\ZHU\Impressions/ Analysis  
OBX|102|TX|||\N\[*] tESTING 2 FOR bIKRAM  
OBX|103|TX|||  
OBX|104|TX|||\ZHU\Therapy Goals  
OBX|105|TX|||\N\[*]  
OBX|106|TX|||  
OBX|107|TX|||\ZHU\Plan/ Recommendations  
OBX|108|TX|||\N\[*]  
OBX|109|TX|||  
OBX|110|TX|||Patient consent for assessment and treatment received (Y/N):  [*]  
OBX|111|TX|||  
OBX|112|TX|||  
OBX|113|TX|||\H\Pam Dawson, Occupational Therapist  
OBX|114|TX|||\N\Date/Time:  \ZU\09/12/19\N\  \ZU\1301  
OBX|115|TX|||                                                                                                                                                           
OBX|116|TX|||\H\ADDENDUM  
OBX|117|TX|||  
OBX|118|TX|||\N\This is a test for addednum and Bikram  
OBX|119|TX|||Signed By:   \ZIU\Pam Dawson  
OBX|120|TX|||\N\Date/Time:   \ZU\09/12/19\N\ \ZU\1314