MSH|^~\&#|SndApp^1.2.3.4.5^ISO|SndFac^1.2.3.4.5^ISO|RcvApp^1.2.3.4.5^ISO|RcvFac^1.2.3.4.5^ISO|20150601160901.12+0100|20150601160810+0500|ORM^O01^ORM_O01|5381904|P|2.3.1|||AL|AL|USA|ASCII|en-US^^ISO639|
PID|1||1032702^^^SndFac&1.2.3.4.5&ISO^MR^ AssignFac&1.2.3.4.5.7&ISO^20190101^20290101||Everywoman^Eve^L^Jr^Dr^^L^^^^G^20000909^20301231^PhD~ Original^Eve^L^Jr^^^M^^^19700601&20000908^G||197006010912|F||1002-5^American Indian or Alaska Native^HL70005~2106-3^White^HL70005|1000 House Lane^Appt 123^Ann Arbor ^MI^99999^USA^H^^WA||^PRN^PH^^1^555^555-8473~^NET^Internet^eve@test.test|^WPN^PH^^1^555^555-1126^12|en-US^^ISO639|M^Married^HL70002|CHR^Christian^HL70006|12345^^^ SndFact&1.2.3.4.5&ISO^AN||12345^MI^20180219||N^Not Hispanic or Latino&HL70189|1025 House Lane^^Ann Arbor ^MI^99999^USA^H^^WA|Y|2|NL^Netherlands^ISO3166||||N|
PV1|1|E^EMERGENCY^HL70004|EMERG^101^01^^^^^^^^DEPID|E^Emergency^HL70007|| | |||857432^Jones^Emily^^^MD^^ AssignAuth&1.2.3.4.5.6&ISO^L^9^1000^DN^ AssignFac&1.2.3.4.5.7&ISO^^G^20100101000000^20330101000000^doctor|||||| |||81456267^^^AssignAuth&1.2.3.4.5.6&ISO^VN|T^Third Party Bill^HL70064||||||||||||||||||||||||20150601135800|
PV2|||^Not feeling well|||||201506011609|||||23432^Smith^Gordon^Denny^Jr^MD^^AssignAuth&1.2.3.4.5.6&ISO^L^9^1000^DN^AssignFac&1.2.3.4.5.7&ISO^^G^20100101000000^20330101000000^doctor||||||||F|N|||2^Urgent^HL72017|
IN1|1|200101^Medicare A and B|2001|Medicare|[Get CMS address]|||123450-1||[check on workman’s comp]|20150101|20151231||Medicare|Everywoman^Eve^L^Jr^Dr^^L^^^^G^20000909^20301231^PhD~Original^Eve^L^Jr^^^M^^^19700601&20000908^G|SEL^Self^HL70063|197006010912|1000 House Lane^Appt 123^Ann Arbor^MI^99999^USA^H^^WA|||||||||||||||||54321-01|
AL1|1|LA^Pollen Allergy^HL70127|^Timothy Grass|MO^Moderate^HL70128|Sneeze|201406|
ORC|NW|ORD777889^SndFac^1.2.3.4.5^ISO||GORD874245^SndFac^1.2.3.4.5^ISO|||1^^^20150601^^R||201506011610|1234567890^PhysicianAssistant^Will^John^III^Mr.^PA^&372526&L^L^^^NPI^^^^G^20140129^^FHL7|5742200012^Radon^Nicholas^^^^^^&372526&L^L^^^NPI|5742200012^Radon^Nicholas^^^^^^&372526&L^L^^^NPI|||||^^^^^^^^Emergency Department|||2^Patient has been informed of responsibility, and agrees to pay for service^HL70339|SndFac^1.2.3.4.5^ISO|Emergency Lane&&911^First Floor^Ann Arbor^MI^99999^USA^S&Service Location&HL70190^^WA^9876^^20100612^^^^^^^Attn: ED Doc in Charge|555-555-9110|Emergency Lane&&912^Medical Building I^Ann Arbor^MI^99999^USA^S&Service Location&HL70190^^WA^9876^^20100813^^^^^^^Attn: Office Manager
OBR|1|ORD777888^SndFac^1.2.3.4.5^ISO||51523-9^Grass Pollen Mix^LN|R|201506011608|201506011608||||||||SER&Serum&HL0070|5742200012^Radon^Nicholas^^^^^^&372526&L^L^^^NPI|^WPN^PH^^1^555^5559908^34||||||||||1^^^20150601^^R|10092000194^Hamlin^Pafford^^^^^^&372526&L^L^^^NPI
NTE|1||Bluegrass is in bloom at the moment|RE|