MSH|^~\&|SndApp^1.2.3.4.5^ISO|SndFac^1.2.3.4.5^ISO|RcvISSApp^1.2.3.4.7^ISO|RcvIISFac^1.2.3.4.8^ISO|20150624084727.655-0500||VXU^V04^VXU_V04|5381910|P|2.5.1|||ER|AL|USA|ASCII|en-US^^ISO639||Z22^CDCPHINVS|SndOrg^L&Legal&HL70204^^^^^^^^1234516|RcvIIS^L^^^^^^^^41526
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|
PD1|||Primary Care Docs^L^^^^CMS&1.2.3.4.6.34&ISO^NPI^^^48295|5742200012^Radon^Nicholas^^^^^^&372526&L^L^^^NPI|P^Part-time student^HL70231|228158008 ^Walking disability (finding)^SCT|Y^Yes, pateint has a living will^HL0315||||02^Reminder/recall -  any method^HL70215|N|20150624|My Place of Worship^L&Legal&HL70204||A|19830615|20150624
ORC|RE|4422^SndFac^1.2.3.4.5^ISO|13696^SndFac^1.2.3.4.5^ISO||CM^Order is complete^HL70038||||201506240840|7824^Jackson^Lily^Suzanne^^^^^NIST-PI-1^L^^^PRN||654^Thomas^Wilma^Elizabeth^^^^^NIST-PI-1^L^^^MD||555-123-4567^BPN^BP^^1^555^1234567|||NISTEHRFAC^NISTEHRFacility^HL70362||||Vaccine Clinic^L^^^^Asgn Auth&1.2.3.6.4.7&ISO^^^^3748295|
RXA|0|1|201506240830||49281-0215-88^TENIVAC^NDC|0.5|mL^mL^UCUM||00^New Record^NIP001|7824^Jackson^Lily^Suzanne^^^^^NIST-PI-1^L^^^PRN|^^^NIST-Clinic-1||||315841|20151216|PMC^Sanofi Pasteur^MVX|||CP|A|201506240831|||||^^^^^^^^Drive in around the corner of High Street and Walnut Avenue|123 Vaccine Lane^^Ann Arbor^MI^99999^USA^L|
RXR|C28161^Intramuscular^NCIT|RD^Right Deltoid^HL70163
OBX|1|CE|30963-3^Vaccine Funding Source^LN|1|PHC70^Private^CDCPHINVS||||||F|||20150624
OBX|2|CE|64994-7^Vaccine Funding Program Eligibility^LN|2|V01^Not VFC Eligible^HL70064||||||F|||20150624|||VXC40^per immunization^CDCPHINVS
OBX|3|CE|69764-9^Document Type^LN|3|253088698300028811170411^Tetanus/Diphtheria (Td) Vaccine VIS^cdcgs1vis||||||F|||20150624
OBX|4|DT|29769-7^Date Vis Presented^LN|3|20150624||||||F|||20150624
ORC|RE|4422^SndFac^1.2.3.4.5^ISO|13696^SndFac^1.2.3.4.5^ISO||CM^Order is complete^HL70038||||201506240840|7824^Jackson^Lily^Suzanne^^^^^NIST-PI-1^L^^^PRN||654^Thomas^Wilma^Elizabeth^^^^^NIST-PI-1^L^^^MD||555-123-4567^BPN^BP^^1^555^1234567|||NISTEHRFAC^NISTEHRFacility^HL70362||||Vaccine Clinic^L^^^^Asgn Auth&1.2.3.6.4.7&ISO^^^^3748295
RXA|0|1|20141012||88^influenza, unspecified formulation^CVX|999|||01^Historical Administration^NIP001|||||||||||CP|A|||||||123 Vaccine Lane^^Ann Arbor^MI^99999^USA^L|
ORC|RE|4422^SndFac^1.2.3.4.5^ISO|13696^SndFac^1.2.3.4.5^ISO||CM^Order is complete^HL70038||||201506240840|7824^Jackson^Lily^Suzanne^^^^^NIST-PI-1^L^^^PRN||654^Thomas^Wilma^Elizabeth^^^^^NIST-PI-1^L^^^MD||555-123-4567^BPN^BP^^1^555^1234567|||NISTEHRFAC^NISTEHRFacility^HL70362||||Vaccine Clinic^L^^^^Asgn Auth&1.2.3.6.4.7&ISO^^^^3748295
RXA|0|1|20131112||88^influenza, unspecified formulation^CVX|999|||01^Historical Administration^NIP001|||||||||||CP|A|||||||123 Vaccine Lane^^Ann Arbor^MI^99999^USA^L|