| 57716-3 | State printed on card NBS card | required |
| 57716-3 | State printed on card NBS card | required |
| 79566-6 | Collection method DBS | optional |
| 79566-6 | Collection method DBS | optional |
| 8339-4 | Birth weight Measured | required |
| 8339-4 | Birth weight Measured | required |
| 58229-6 | Weight when spec taken Measured | optional |
| 58229-6 | Weight when spec taken Measured | optional |
| 57715-5 | Birth time | required |
| 57715-5 | Birth time | required |
| 73806-2 | Nwbrn age hours | optional |
| 73806-2 | Nwbrn age hours | optional |
| 57722-1 | Birth plurality | required |
| 57722-1 | Birth plurality | required |
| 57714-8 | OB est of GA | required |
| 57714-8 | OB est of GA | required |
| 57713-0 | Inf factors affecting NBS imp | required |
| 57713-0 | Inf factors affecting NBS imp | required |
| 67703-9 | Other Inf factors affecting NBS imp | conditional |
| 67703-9 | Other Inf factors affecting NBS imp | conditional |
| 67706-2 | Mat factors affecting NBS imp | optional |
| 67706-2 | Mat factors affecting NBS imp | optional |
| 67707-0 | Other mat factors affecting NBS imp | conditional |
| 67707-0 | Other mat factors affecting NBS imp | conditional |
| 77739-1 | Mother's HBV surface Ag Ql | conditional |
| 77739-1 | Mother's HBV surface Ag Ql | conditional |
| 57712-2 | Highest level of education Mother | optional |
| 57712-2 | Highest level of education Mother | optional |
| 67704-7 | Feeding types | required |
| 67704-7 | Feeding types | required |
| 67705-4 | Other feeding types | conditional |
| 67705-4 | Other feeding types | conditional |
| 79569-0 | Blood product Gvn Type | conditional |
| 79569-0 | Blood product Gvn Type | conditional |
| 62317-3 | Date last blood product transfusion | optional |
| 62317-3 | Date last blood product transfusion | optional |
| 58232-0 | Hearing loss risk indicators | conditional |
| 58232-0 | Hearing loss risk indicators | conditional |
| 54106-0 | NB hearing scn meth | conditional |
| 54106-0 | NB hearing scn meth | conditional |
| 54108-6 | NB hearing scn Ear-L | conditional |
| 54108-6 | NB hearing scn Ear-L | conditional |
| 54109-4 | NB hearing scn Ear-R | conditional |
| 54109-4 | NB hearing scn Ear-R | conditional |
| 73700-7 | CCHD NBS interp | conditional |
| 73700-7 | CCHD NBS interp | conditional |
| 73698-3 | CCHD SaO2 scrn not prfrmd | conditional |
| 73698-3 | CCHD SaO2 scrn not prfrmd | conditional |
| 57723-9 | Unique bar code # Current sample | required |
| 57723-9 | Unique bar code # Current sample | required |
| 57711-4 | Unique bar code # Initial sample | conditional |
| 57711-4 | Unique bar code # Initial sample | conditional |
| 62323-1 | Post-discharge provider ID | conditional |
| 62323-1 | Post-discharge provider ID | conditional |
| 62324-9 | Post-discharge provider name Provider | conditional |
| 62324-9 | Post-discharge provider name Provider | conditional |
| 62325-6 | Post-discharge provider practice ID | conditional |
| 62325-6 | Post-discharge provider practice ID | conditional |
| 62326-4 | Post-discharge provider practice name | conditional |
| 62326-4 | Post-discharge provider practice name | conditional |
| 62327-2 | Post-disch prov practice address | conditional |
| 62327-2 | Post-disch prov practice address | conditional |
| 62328-0 | Post-disch prov practice phone # | conditional |
| 62328-0 | Post-disch prov practice phone # | conditional |
| 62329-8 | Birth hospital ID | conditional |
| 62329-8 | Birth hospital ID | conditional |
| 62330-6 | Birth hospital name | conditional |
| 62330-6 | Birth hospital name | conditional |
| 62331-4 | Birth hospital address | conditional |
| 62331-4 | Birth hospital address | conditional |
| 62332-2 | Birth hospital phone # | conditional |
| 62332-2 | Birth hospital phone # | conditional |