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MSH|^~\&|||||20251115044351-0700||VXU^V04^VXU_V04|J22X15.h3|P|2.5.1|||ER|AL|||||Z22^CDCPHINVS| PID|1||J22X15^^^AIRA-TEST^MR||NorthamptonAIRA^EisigAIRA^Aitan^^^^L|CulbersonAIRA^DanutaAIRA^^^^^M|20211107|M||2106-3^White^CDCREC|1621 Leldermalsen Pl^^Seneca^MI^49256^USA^P||^PRN^PH^^^517^6005363|||||||||2186-5^not Hispanic or Latino^CDCREC| PD1|||||||||||02^Reminder/Recall - any method^HL70215|||||A|20251115|20251115| NK1|1|NorthamptonAIRA^DanutaAIRA^^^^^L|MTH^Mother^HL70063|1621 Leldermalsen Pl^^Seneca^MI^49256^USA^P|^PRN^PH^^^517^6005363| ORC|RE||J22X15.3^AIRA|||||||I-23432^Burden^Donna^A^^^^^NIST-AA-1^^^^PRN||57422^RADON^NICHOLAS^^^^^^NIST-AA-1^L^^^PRN| RXA|0|1|20251115||21^Varicella^CVX|0.5|mL^milliliters^UCUM||00^Administered^NIP001||||||Y5841RR||MSD^Merck and Co^MVX|||CP|A| RXR|C38299^^NCIT|RA^^HL70163| OBX|1|CE|64994-7^Vaccine funding program eligibility category^LN|1|V02^VFC eligible - Medicaid/Medicaid Managed Care^HL70064||||||F|||20251115|||VXC40^Eligibility captured at the immunization level^CDCPHINVS| OBX|2|CE|30956-7^Vaccine Type^LN|2|21^Varicella^CVX||||||F| OBX|3|TS|29768-9^Date vaccine information statement published^LN|2|20080313||||||F| OBX|4|TS|29769-7^Date vaccine information statement presented^LN|2|20251115||||||F|
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