| 21112-8 | Birth date | |
| 45965-1 | Name:-:Pt:^Patient:Set: | |
| 46098-0 | Sex | |
| 32624-9 | Race | |
| 21838-8 | Ethnicity Computed | |
| 42077-8 | Phone # | |
| 56795-8 | Account # | |
| 45396-9 | Social Security # | |
| 21847-9 | Usual occupation | |
| 21844-6 | Hx of Usual industry | |
| 56796-6 | Emergency contact info Pnl | |
| 52463-7 | Patient ID # or Provider Acct # | |
| 56797-4 | Episode unique ID | |