| 77965-2 | Immediate national notifiable condition:Find:Pt:^Event:Ord: | required |
| 68329-2 | Country of origin:Loc:Pt:^Patient:Nom: | required |
| 77983-5 | Country of usual residence | required |
| 77966-0 | Reporting state:Loc:Pt:^Event:Nom: | required |
| 77967-8 | Reporting county:Loc:Pt:^Event:Nom: | required |
| 77968-6 | National reporting jurisdiction:Loc:Pt:^Event:Nom: | required |
| 77969-4 | Jurisdiction code:ID:Pt:^Event:Nom: | optional |
| 77970-2 | Date of initial report:TmStp:Pt:^Event:Qn: | required |
| 48766-0 | Source of info | optional |
| 52831-5 | Postal code Fclty | optional |
| 77972-8 | Earliest date reported to county:TmStp:Pt:^Event:Qn: | optional |
| 77973-6 | Earliest date reported to state:TmStp:Pt:^Event:Qn: | required |
| 77974-4 | Hospitalized for condition | optional |
| 8656-1 | Hospital admission date | optional |
| 8649-6 | Hospital discharge date | optional |
| 78033-8 | Hosp stay duration | optional |
| 77975-1 | Earliest Date of Dx | required |
| 11368-8 | Illness or injury onset date and time | required |
| 77976-9 | Illness or injury end date | optional |
| 77977-7 | Illness duration | optional |
| 77978-5 | Pt died from illness | required |
| 31211-6 | Date of death | required |
| 77979-3 | Case investigation start date:Date:Pt:^Event:Qn: | optional |
| 77980-1 | Case is associated with a known outbreak:Find:Pt:^Event:Ord: | required |
| 77981-9 | Case outbreak name:ID:Pt:^Event:Nom: | required |
| 77982-7 | Jurisdiction where disease acquired:Loc:Pt:^Patient:Nom: | required |
| 77984-3 | Country exp to illness | required |
| 77985-0 | St or Prov exposure to illness | required |
| 77986-8 | City of exposure to illness | required |
| 77987-6 | Co. of exposure to illness | required |
| 77988-4 | Binational reporting criteria:Type:Pt:^Event:Nom:CDC.PHIN | required |
| 77989-2 | Disease transmission mode | optional |
| 77990-0 | Case class status:Type:Pt:^Event:Nom:CDC.PHIN | required |
| 77991-8 | Week counted for Morbidity and Mortality Weekly Report:Num:Pt:^Event:Qn:CDC.PHIN | required |
| 77992-6 | Year included in Morbidity and Mortality Weekly Report:Date:Pt:^Event:Qn:CDC.PHIN | required |
| 77993-4 | State notifiable condition case identifier:ID:Pt:^Event:Nom: | optional |
| 77994-2 | Date of first report to Centers for Disease Control and Prevention:TmStp:Pt:^Event:Qn:CDC.PHIN | required |
| 77995-9 | Date of first report to public health department:TmStp:Pt:^Event:Qn: | required |
| 77996-7 | Preg stat at illness cond | optional |
| 74549-7 | Reporter of adverse event or unsafe condition:Pn:Pt:^Event:Nom: | required |
| 74548-9 | Reporter phone number:Tele:Pt:^Event:Nom: | required |
| 74547-1 | Reporter email:EmailAddr:Pt:^Event:Nom: | required |
| 77997-5 | Legacy case identifier:ID:Pt:^Event:Nom:CDC.PHIN | required |
| 77998-3 | Age at time of case investigation:Time:Pt:^Patient:Qn: | required |
| 77999-1 | Case notification comment:Imp:Pt:^Event:Nom: | optional |
| 78000-7 | Case notification panel:-:Pt:^Patient:-:CDC.PHIN | |