| 34133-9 | Summary of episode note | required |
| 48764-5 | Summary purpose CCD Doc | optional |
| 48768-6 | Payment sources Doc | optional |
| 42348-3 | Adv healthcare directives | optional |
| 47420-5 | Functional status note | optional |
| 11450-4 | Problem list Reported | optional |
| 11323-3 | General health Reported | optional |
| 10157-6 | Hx of fam member ds note | optional |
| 29762-2 | Social hx note | optional |
| 48765-2 | Allergies &or adverse reactions Doc | optional |
| 10160-0 | Hx of Medication use | optional |
| 46264-8 | Hx medical device use | optional |
| 11369-6 | Hx of Immunization note | optional |
| 8716-3 | Vital signs note | optional |
| 30954-2 | Relevant dx tests/lab data note | optional |
| 47519-4 | Procedures Hx Doc | optional |
| 46240-8 | Hx of Hospitalizations+OP visits | optional |
| 18776-5 | Plan of care note | optional |
| 48767-8 | Annotation comment Imp | optional |
| 33999-4 | Status {Dx} | required |
| 48766-0 | Source of info | required |
| 48769-4 | Continuity of Care Pnl | |