MSH|^~\&|NISTEHRAPP|NISTEHRFAC|NISTIISAPP|NISTIISFAC|20150624084727.655-0500||VXU^V04^VXU_V04|NIST-IZ-AD-2.1_Send_V04_Z22|P|2.5.1|||ER|AL|||||Z22^CDCPHINVS|NISTEHRFAC|NISTIISFAC
PID|1||90012^^^NIST-MPI-1^MR||Wong^Elise^^^^^L||19830615|F||2028-9^Asian^CDCREC|9200 Wellington Trail^^Bozeman^MT^59715^USA^P||^PRN^PH^^^406^5557896~^NET^^Elise.Wong@isp.com|||||||||2186-5^Not Hispanic or Latino^CDCREC||N|1|||||N
PD1|||||||||||02^Reminder/recall - any method^HL70215|N|20150624|||A|19830615|20150624
ORC|RE|4422^NIST-AA-IZ-2|13696^NIST-AA-IZ-2|||||||7824^Jackson^Lily^Suzanne^^^^^NIST-PI-1^L^^^PRN||654^Thomas^Wilma^Elizabeth^^^^^NIST-PI-1^L^^^MD|||||NISTEHRFAC^NISTEHRFacility^HL70362|
RXA|0|1|20150624||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
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||38760^NIST-AA-IZ-2|||||||7824^Jackson^Lily^Suzanne^^^^^NIST-PI-1^L^^^PRN|||||||NISTEHRFAC^NISTEHRFacility^HL70362
RXA|0|1|20141012||88^influenza, unspecified formulation^CVX|999|||01^Historical Administration^NIP001|||||||||||CP|A
ORC|RE||35508^NIST-AA-IZ-2|||||||7824^Jackson^Lily^Suzanne^^^^^NIST-PI-1^L^^^PRN|||||||NISTEHRFAC^NISTEHRFacility^HL70362
RXA|0|1|20131112||88^influenza, unspecified formulation^CVX|999|||01^Historical Administration^NIP001|||||||||||CP|A