MSH|^~\&|ADM|RCH|||202001281010||ADT^A08|4157309|D|2.2|||AL|NE
EVN|A08|202001281010||||202001281010
PID|1|FHATVIG0013160|RC00008115|RC7789|TESTVPNEW^LADY^Y||19781122|F|||1111 99 STREET^^SURREY^BC^V1V 1V1|||||||RC001080/19|9715143138
PV1|1|P|RC.MFM||||.UNATTACH^Unattach^^^^^^^^^^^XX|||||||||||RCR|||||||||||||||||||||RCH|||||202001281010|
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||||.UNATTACH^Unattach^^^^^^^OTH|
ZFH|LUMED|||||||||EDPRERCR