| 48765-2 | Allergies &or adverse reactions Doc | required |
| 51848-0 | Eval note | required |
| 51847-2 | Eval+Plan note | required |
| 10154-3 | Chief complaint Reported | required |
| 10157-6 | Hx of fam member ds note | required |
| 10210-3 | Phys find General status | required |
| 10164-2 | Hx of Pres illness | optional |
| 11369-6 | Hx of Immunization note | optional |
| 69730-0 | Instructions | optional |
| 10160-0 | Hx of Medication use | required |
| 11348-0 | Hx of Past illness note | required |
| 29545-1 | Physical findings note | required |
| 18776-5 | Plan of care note | required |
| 11450-4 | Problem list Reported | optional |
| 47519-4 | Procedures Hx Doc | optional |
| 29299-5 | Reason for visit | required |
| 46239-0 | Chief complaint+Reason for visit | required |
| 30954-2 | Relevant dx tests/lab data note | required |
| 10187-3 | Review of systems | required |
| 29762-2 | Social hx note | required |
| 8716-3 | Vital signs note | required |
| 72228-0 | H+P C-CDA R1.1+2.0+2.1 Sections | |