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Original Message

MSH|^~\&|HMS|HMS66|FLHIE||20250418140022-0500||ADT^A03^ADT_A03|FF4C2DDB-6917-42C4-A|T|2.5.1|||AL|AL
EVN|A03|20250418140022-0500||O|||HMS66 PID|1||6642134656^^^HMS66^MR^HMS66|6642134656|POTTER^NIC PAYMENT 05^X^^^^L|^^^^^^M|19860101|M||2106-3^WHITE^CDCREC|555 TEST DR^^TALLAHASSEE^FL^32311^USA^L||(660)441-1485^PRN^PH^^^^^^~^NET^^mudassir.ali@flhealth.gov||ENGLISH|^^HL7002||6642134656||||2186-5^Non-Hispanic/Latino^CDCREC PV1|1|O^Outpatient^HL70004||R^Routine^HL70007|||1891834727^APPLE^ANDY||||||||||||19255|||||||||||||||||30^Still patient or expected to return for outpatient services^HL70112||||||||20250110100000|20250110100000 PV2|||^Headache, Vomit DG1|1||Z00.00^Encntr for general adult medical exam w/o abnormal findings^ICD10CM|Encntr for general adult medical exam w/o abnormal findings||W IN1|1|650101198601|53|ALLIED GROUP||||||||20190101||||POTTER^NIC PAYMENT 05^X^^^^L|SEL|19860101|555 TEST DR^^TALLAHASSEE^FL^32311^USA^L||||||||||||||||||||||||M||||||650101198601 IN1|2|650101198601|53|ALLIED GROUP||||||||20190101||||POTTER^NIC PAYMENT 05^X^^^^L|SEL|19860101|555 TEST DR^^TALLAHASSEE^FL^32311^USA^L||||||||||||||||||||||||M||||||650101198601 IN1|3|5435346556|1|AETNA||||||||20190101||||POTTER^NIC PAYMENT 05^X^^^^L|SEL|19860101|555 TEST DR^^TALLAHASSEE^FL^32311^USA^L||||||||||||||||||||||||M||||||5435346556 IN1|4|5435346556|1|AETNA||||||||20190101||||POTTER^NIC PAYMENT 05^X^^^^L|SEL|19860101|555 TEST DR^^TALLAHASSEE^FL^32311^USA^L||||||||||||||||||||||||M||||||5435346556 IN1|5|3123213123|8|MEDICAID||||||||20220101||||POTTER^NIC PAYMENT 05^X^^^^L|SEL|19860101|555 TEST DR^^TALLAHASSEE^FL^32311^USA^L||||||||||||||||||||||||M||||||3123213123 IN1|6|3123213123|8|MEDICAID||||||||20220101||||POTTER^NIC PAYMENT 05^X^^^^L|SEL|19860101|555 TEST DR^^TALLAHASSEE^FL^32311^USA^L||||||||||||||||||||||||M||||||3123213123 IN1|7|213213213|60|UNITED HEALTHCARE||||||||20220101||||POTTER^NIC PAYMENT 05^X^^^^L|SEL|19860101|555 TEST DR^^TALLAHASSEE^FL^32311^USA^L||||||||||||||||||||||||M||||||213213213 IN1|8|543534543564|11|BLUE CROSS BLUE SHIELD FL||||||||20190101||||POTTER^NIC PAYMENT 05^X^^^^L|SEL|19860101|555 TEST DR^^TALLAHASSEE^FL^32311^USA^L||||||||||||||||||||||||M||||||543534543564 IN1|9|1980980890|47|CAPITAL HEALTH PLAN||||||||20190101||||POTTER^NIC PAYMENT 05^X^^^^L|SEL|19860101|555 TEST DR^^TALLAHASSEE^FL^32311^USA^L||||||||||||||||||||||||M||||||1980980890 IN1|10|64546546|10|GOLDEN RULE||||||||20190101||||POTTER^NIC PAYMENT 05^X^^^^L|SEL|19860101|555 TEST DR^^TALLAHASSEE^FL^32311^USA^L||||||||||||||||||||||||M||||||64546546 IN1|11|53543534|58|BLUE CROSS BLUE SHIELD FL - DENTAL||||||||20190101||||POTTER^NIC PAYMENT 05^X^^^^L|SEL|19860101|555 TEST DR^^TALLAHASSEE^FL^32311^USA^L||||||||||||||||||||||||M||||||53543534 IN1|12|54635|20|BURNETT PAYS||||||||20190101||||POTTER^NIC PAYMENT 05^X^^^^L|SEL|19860101|555 TEST DR^^TALLAHASSEE^FL^32311^USA^L||||||||||||||||||||||||M||||||54635 IN1|13|213213213|60|UNITED HEALTHCARE||||||||20220101||||POTTER^NIC PAYMENT 05^X^^^^L|SEL|19860101|555 TEST DR^^TALLAHASSEE^FL^32311^USA^L||||||||||||||||||||||||M||||||213213213 IN1|14|543534543564|11|BLUE CROSS BLUE SHIELD FL||||||||20190101||||POTTER^NIC PAYMENT 05^X^^^^L|SEL|19860101|555 TEST DR^^TALLAHASSEE^FL^32311^USA^L||||||||||||||||||||||||M||||||543534543564 IN1|15|1980980890|47|CAPITAL HEALTH PLAN||||||||20190101||||POTTER^NIC PAYMENT 05^X^^^^L|SEL|19860101|555 TEST DR^^TALLAHASSEE^FL^32311^USA^L||||||||||||||||||||||||M||||||1980980890 IN1|16|64546546|10|GOLDEN RULE||||||||20190101||||POTTER^NIC PAYMENT 05^X^^^^L|SEL|19860101|555 TEST DR^^TALLAHASSEE^FL^32311^USA^L||||||||||||||||||||||||M||||||64546546 IN1|17|53543534|58|BLUE CROSS BLUE SHIELD FL - DENTAL||||||||20190101||||POTTER^NIC PAYMENT 05^X^^^^L|SEL|19860101|555 TEST DR^^TALLAHASSEE^FL^32311^USA^L||||||||||||||||||||||||M||||||53543534 IN1|18|54635|20|BURNETT PAYS||||||||20190101||||POTTER^NIC PAYMENT 05^X^^^^L|SEL|19860101|555 TEST DR^^TALLAHASSEE^FL^32311^USA^L||||||||||||||||||||||||M||||||54635

Parsed Message

ADT_A03
- MSH
- EVN

|^~\&HMSHMS66FLHIE20250418140022-0500ADTA03ADT_A03FF4C2DDB-6917-42C4-AT2.5.1ALALA0320250418140022-0500OHMS66 PID16642134656HMS66MRHMS666642134656POTTERNIC PAYMENT 05XLM19860101M2106-3WHITECDCREC555 TEST DRTALLAHASSEEFL32311USAL(660)441-1485PRNPHNETmudassir.ali@flhealth.govENGLISHHL700266421346562186-5Non-Hispanic/LatinoCDCREC PV11OOutpatientHL70004RRoutineHL700071891834727APPLEANDY1925530Still patient or expected to return for outpatient servicesHL701122025011010000020250110100000 PV2Headache, Vomit DG11Z00.00Encntr for general adult medical exam w/o abnormal findingsICD10CMEncntr for general adult medical exam w/o abnormal findingsW IN1165010119860153ALLIED GROUP20190101POTTERNIC PAYMENT 05XLSEL19860101555 TEST DRTALLAHASSEEFL32311USALM650101198601 IN1265010119860153ALLIED GROUP20190101POTTERNIC PAYMENT 05XLSEL19860101555 TEST DRTALLAHASSEEFL32311USALM650101198601 IN1354353465561AETNA20190101POTTERNIC PAYMENT 05XLSEL19860101555 TEST DRTALLAHASSEEFL32311USALM5435346556 IN1454353465561AETNA20190101POTTERNIC PAYMENT 05XLSEL19860101555 TEST DRTALLAHASSEEFL32311USALM5435346556 IN1531232131238MEDICAID20220101POTTERNIC PAYMENT 05XLSEL19860101555 TEST DRTALLAHASSEEFL32311USALM3123213123 IN1631232131238MEDICAID20220101POTTERNIC PAYMENT 05XLSEL19860101555 TEST DRTALLAHASSEEFL32311USALM3123213123 IN1721321321360UNITED HEALTHCARE20220101POTTERNIC PAYMENT 05XLSEL19860101555 TEST DRTALLAHASSEEFL32311USALM213213213 IN1854353454356411BLUE CROSS BLUE SHIELD FL20190101POTTERNIC PAYMENT 05XLSEL19860101555 TEST DRTALLAHASSEEFL32311USALM543534543564 IN19198098089047CAPITAL HEALTH PLAN20190101POTTERNIC PAYMENT 05XLSEL19860101555 TEST DRTALLAHASSEEFL32311USALM1980980890 IN1106454654610GOLDEN RULE20190101POTTERNIC PAYMENT 05XLSEL19860101555 TEST DRTALLAHASSEEFL32311USALM64546546 IN1115354353458BLUE CROSS BLUE SHIELD FL - DENTAL20190101POTTERNIC PAYMENT 05XLSEL19860101555 TEST DRTALLAHASSEEFL32311USALM53543534 IN1125463520BURNETT PAYS20190101POTTERNIC PAYMENT 05XLSEL19860101555 TEST DRTALLAHASSEEFL32311USALM54635 IN11321321321360UNITED HEALTHCARE20220101POTTERNIC PAYMENT 05XLSEL19860101555 TEST DRTALLAHASSEEFL32311USALM213213213 IN11454353454356411BLUE CROSS BLUE SHIELD FL20190101POTTERNIC PAYMENT 05XLSEL19860101555 TEST DRTALLAHASSEEFL32311USALM543534543564 IN115198098089047CAPITAL HEALTH PLAN20190101POTTERNIC PAYMENT 05XLSEL19860101555 TEST DRTALLAHASSEEFL32311USALM1980980890 IN1166454654610GOLDEN RULE20190101POTTERNIC PAYMENT 05XLSEL19860101555 TEST DRTALLAHASSEEFL32311USALM64546546 IN1175354353458BLUE CROSS BLUE SHIELD FL - DENTAL20190101POTTERNIC PAYMENT 05XLSEL19860101555 TEST DRTALLAHASSEEFL32311USALM53543534 IN1185463520BURNETT PAYS20190101POTTERNIC PAYMENT 05XLSEL19860101555 TEST DRTALLAHASSEEFL32311USALM54635

Parsed HL7v2 Message

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