MSH|^~\&|ADM|FCH|||201911040755||ADT^A01|4098653|D|2.2|||AL|NE
EVN|A01|201911040755||||201911040752
PID|1|FHATVIG0012296|FC00002115|FC2167|PCSTEST^FUTURESTATE||19341104|F|||3 Pine Street^^Hope^BC^C3F4D6|||||||FC000035/19|
PV1|1|I|FC-1S^FC1S-112^1|UE|||EDMTEST^EDM Test Provider^Upgrade^^^^^^^^^^XX|||ACE||||||||IN|||||||||||||||||||||FCH|||||201911040752|
PV2||WH^Ward Hospice|
OBX|1|TX|ADM CURRES^Residing at current add. since (DD/MM/YY)^ADM||19940404||||||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^or Bangladesh in the last 12 months?^ADM||N^NO||||||F
OBX|5|CE|ADM MRSA2^correctional/shelter in the last 6 months?^ADM||N^NO||||||F
OBX|6|CE|CP H ADCAT^Admission reason:^ADM||SYM^Symptom Management||||||F
OBX|7|CE|CP H ADFRM^Admitted From:^ADM||HOME^Home||||||F
OBX|8|CE|CP H ADMCT^Hospice Admission Category:^ADM||2^Regular Admission||||||F
OBX|9|CE|CP H DNRF^DNR on File:^ADM||Y^Yes||||||F
OBX|10|TX|CP H DTPGM^HPC Program Registration Date:^ADM||20191025||||||F
OBX|11|CE|CP H DXCA^Is Primary Diagnosis Cancer or Non-Cancer:^ADM||CA^Cancer||||||F
OBX|12|CE|CP H OTHH^Admit to Hospital in Past 90 Days:^ADM||N^No||||||F
OBX|13|TX|CP H PAINA^Pain Score on Admission^ADM||8||||||F
OBX|14|TX|CP H PND2^Date:^ADM||20191104||||||F
OBX|15|TX|CP H PPS^PPS:^ADM||45||||||F
OBX|16|TX|CP H PPSD^Date:^ADM||20191104||||||F
OBX|17|TX|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N||||||F
ZFD|EDMTEST^EDM Test Provider^Upgrade^^^^^^DOC||||EDMTEST^EDM Test Provider^Upgrade^^^^^^DOC|EDMTEST^EDM Test Provider^Upgrade^^^^^^DOC|
ZFH|LUMED||||||