FHS|^~\&|WIR11.3.2^^^|WIR^^^|||20200514||1218918.update|||
BHS|^~\&|WIR11.3.2^^^|WIR^^^|||20200514|||||
MSH|^~\&|WIR11.3.2^^^|WIR^^^||WIRPH^^^|20200514||VXU^V04|2020051409183900|P^|2.3.1^^|||ER
PID|||3019189^^^^^||NEW^BORNGIRL^^^^^^||20180711|F||W^^^^^|800 ECLIPSE CENTER^^BELOIT^WI^53511^^^^WI105^^||(608)999-9999^PRN^PH^^^608^9999^^|||||||||NH^^^^^|||||||
PD1|||||||||||02^^^^^|Y||A
NK1|1|NEW^BORNGIRL^^^^^^|18^SELF^HL70063^^^|800 ECLIPSE CENTER^^BELOIT^WI^53511^^^^^^|(608)999-9999^PRN^PH^^^608^9999999^^
NK1|2|ZZZGIRL^MOTHER^^^^^^|G8^OTHER RELATIONSHIP^HL70063^^^|800 LEFT ST^^MILWAUKEE^WI^53212^^^^^^|(414)999-9999^PRN^PH^^^414^9999999^^
NK1|3|ZZZGIRL^MOTHER^^^^^^|32^MOTHER^HL70063^^^|800 LEFT ST^^MILWAUKEE^WI^53212^^^^^^|(414)999-9999^PRN^PH^^^414^9999999^^
RXA|0|999|20180711|20180711|08^HepB pediatric^CVX^90744^HepB pediatric^CPT|1.0|||00^^^^^~38133698^WIR immunization id^IMM_ID^^^|^Test  Doctor^^^^^^^^^^^^^|^^^WIR Physicians^^^^^^^^^^^||||GSKFlulaval||SKB^SKB^MVX^^^
RXR|IM^^^^^|LA^^^^^
RXA|0|999|20180710|20180711|20^DtaP^CVX^90700^DtaP^CPT|1.0|||01^^^^^~38150833^WIR immunization id^IMM_ID^^^||||||||
BTS|1|
FTS|1|